Provider Demographics
NPI:1639236987
Name:BEARD, CYRIL J III (DDS)
Entity Type:Individual
Prefix:DR
First Name:CYRIL
Middle Name:J
Last Name:BEARD
Suffix:III
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 HARDING RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-2018
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 HARDING RD
Practice Address - Street 2:SUITE 105
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-2018
Practice Address - Country:US
Practice Address - Phone:732-224-8900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ148241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice