Provider Demographics
NPI:1851665020
Name:BEARDMORE, MARGARET MARY (RDH)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:MARY
Last Name:BEARDMORE
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:MARGARET
Other - Middle Name:MARY
Other - Last Name:BOYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDH
Mailing Address - Street 1:2930 11TH AVE
Mailing Address - Street 2:
Mailing Address - City:EVANS
Mailing Address - State:CO
Mailing Address - Zip Code:80620-1011
Mailing Address - Country:US
Mailing Address - Phone:970-353-9403
Mailing Address - Fax:970-350-4644
Practice Address - Street 1:1006 A ST
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80631-2021
Practice Address - Country:US
Practice Address - Phone:970-352-0048
Practice Address - Fax:970-352-1120
Is Sole Proprietor?:No
Enumeration Date:2012-03-05
Last Update Date:2012-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO904268124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist