Provider Demographics
NPI:1013237262
Name:BEESTON, DAVID J (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:J
Last Name:BEESTON
Suffix:
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 1:2166 KAYS CREEK DR
Mailing Address - Street 2:
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84040-7880
Mailing Address - Country:US
Mailing Address - Phone:402-658-7783
Mailing Address - Fax:
Practice Address - Street 1:3626 W 5600 S
Practice Address - Street 2:
Practice Address - City:ROY
Practice Address - State:UT
Practice Address - Zip Code:84067-9161
Practice Address - Country:US
Practice Address - Phone:801-985-2273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-09
Last Update Date:2010-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7693825-99211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice