Provider Demographics
NPI:1619990579
Name:BEESLEY, NORMAN ERNEST (DMD)
Entity Type:Individual
Prefix:DR
First Name:NORMAN
Middle Name:ERNEST
Last Name:BEESLEY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9598 PROTOTYPE CT
Mailing Address - Street 2:SUITE A
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89521-5916
Mailing Address - Country:US
Mailing Address - Phone:775-852-8181
Mailing Address - Fax:775-852-8199
Practice Address - Street 1:9598 PROTOTYPE CT
Practice Address - Street 2:SUITE A
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89521-5916
Practice Address - Country:US
Practice Address - Phone:775-852-8181
Practice Address - Fax:775-852-8199
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV6731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice