Provider Demographics
NPI:1700653607
Name:BEAM TEAM DENTAL LIMITED LIABILITY COMPANY
Entity type:Organization
Organization Name:BEAM TEAM DENTAL LIMITED LIABILITY COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CALEB
Authorized Official - Middle Name:SETH
Authorized Official - Last Name:BEAM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:304-619-4522
Mailing Address - Street 1:5 N MORGANTOWN ST
Mailing Address - Street 2:
Mailing Address - City:FAIRCHANCE
Mailing Address - State:PA
Mailing Address - Zip Code:15436-1180
Mailing Address - Country:US
Mailing Address - Phone:724-564-9010
Mailing Address - Fax:
Practice Address - Street 1:5 N MORGANTOWN ST
Practice Address - Street 2:
Practice Address - City:FAIRCHANCE
Practice Address - State:PA
Practice Address - Zip Code:15436-1180
Practice Address - Country:US
Practice Address - Phone:724-564-9010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-11
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental