Provider Demographics
NPI:1477386548
Name:MATTHEW BEAUCHEMIN DMD PA
Entity type:Organization
Organization Name:MATTHEW BEAUCHEMIN DMD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:ORESTE
Authorized Official - Last Name:BEAUCHEMIN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:954-394-5926
Mailing Address - Street 1:1709 SONGBIRD CT
Mailing Address - Street 2:
Mailing Address - City:LENOIR
Mailing Address - State:NC
Mailing Address - Zip Code:28645-6273
Mailing Address - Country:US
Mailing Address - Phone:954-394-5926
Mailing Address - Fax:
Practice Address - Street 1:505 REALTY ST SW
Practice Address - Street 2:
Practice Address - City:LENOIR
Practice Address - State:NC
Practice Address - Zip Code:28645-5567
Practice Address - Country:US
Practice Address - Phone:828-754-2600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-23
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty