Provider Demographics
NPI:1952033037
Name:LEONARD W. BEESLEY, DDS
Entity Type:Organization
Organization Name:LEONARD W. BEESLEY, DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LEONARD
Authorized Official - Middle Name:W
Authorized Official - Last Name:BEESLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:906-482-8602
Mailing Address - Street 1:1111 HECLA ST
Mailing Address - Street 2:
Mailing Address - City:HANCOCK
Mailing Address - State:MI
Mailing Address - Zip Code:49930-1000
Mailing Address - Country:US
Mailing Address - Phone:906-482-8602
Mailing Address - Fax:
Practice Address - Street 1:1111 HECLA ST
Practice Address - Street 2:
Practice Address - City:HANCOCK
Practice Address - State:MI
Practice Address - Zip Code:49930-1000
Practice Address - Country:US
Practice Address - Phone:906-482-8602
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-28
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
No1223D0001XDental ProvidersDentistDental Public HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
10288OtherDELTA DENTAL OF MICHIGAN