Provider Demographics
NPI:1295995710
Name:ROBERT G. BEEBE, JR. DMD, PA
Entity type:Organization
Organization Name:ROBERT G. BEEBE, JR. DMD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:G
Authorized Official - Last Name:BEEBE
Authorized Official - Suffix:JR
Authorized Official - Credentials:DMD
Authorized Official - Phone:843-875-7753
Mailing Address - Street 1:9545 DORCHESTER RD
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29485-8750
Mailing Address - Country:US
Mailing Address - Phone:843-875-7753
Mailing Address - Fax:843-851-2120
Practice Address - Street 1:9545 DORCHESTER RD
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29485-8750
Practice Address - Country:US
Practice Address - Phone:843-875-7753
Practice Address - Fax:843-851-2120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-10
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC28491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty