Provider Demographics
NPI:1790997799
Name:BEESON, DENNIS CHARLES (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:CHARLES
Last Name:BEESON
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4699 HAMANN PKWY
Mailing Address - Street 2:
Mailing Address - City:WILLOUGHBY
Mailing Address - State:OH
Mailing Address - Zip Code:44094-5631
Mailing Address - Country:US
Mailing Address - Phone:440-954-3272
Mailing Address - Fax:440-951-1246
Practice Address - Street 1:4699 HAMANN PKWY
Practice Address - Street 2:
Practice Address - City:WILLOUGHBY
Practice Address - State:OH
Practice Address - Zip Code:44094-5631
Practice Address - Country:US
Practice Address - Phone:440-954-3272
Practice Address - Fax:440-951-1246
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH138401223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics