Provider Demographics
NPI:1639529332
Name:LITCHFIELD, BEVERLEY (RDH, DHSC)
Entity Type:Individual
Prefix:
First Name:BEVERLEY
Middle Name:
Last Name:LITCHFIELD
Suffix:
Gender:F
Credentials:RDH, DHSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:195 PLEASANT VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04021-3312
Mailing Address - Country:US
Mailing Address - Phone:207-233-0237
Mailing Address - Fax:
Practice Address - Street 1:6 FUNDY RD
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04105-1779
Practice Address - Country:US
Practice Address - Phone:207-781-2272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-14
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME799124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist