Provider Demographics
NPI:1851576995
Name:BEESON, PERRY HAMPTON JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:PERRY
Middle Name:HAMPTON
Last Name:BEESON
Suffix:JR
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:PO BOX 9246
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28680-9246
Mailing Address - Country:US
Mailing Address - Phone:828-437-7070
Mailing Address - Fax:828-437-7950
Practice Address - Street 1:218 BURKEMONT AVE
Practice Address - Street 2:
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655
Practice Address - Country:US
Practice Address - Phone:828-437-7070
Practice Address - Fax:828-437-7950
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-08
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4320122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8940576Medicaid
NC8940576Medicaid