Provider Demographics
NPI:1780605105
Name:BEYER, PHILIP K (DDS, PC)
Entity type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:K
Last Name:BEYER
Suffix:
Gender:M
Credentials:DDS, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 MCGEE DRIVE SUTE 128
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-6722
Mailing Address - Country:US
Mailing Address - Phone:405-321-7392
Mailing Address - Fax:405-321-7391
Practice Address - Street 1:2500 MCGEE DRIVE SUTE 128
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072-6722
Practice Address - Country:US
Practice Address - Phone:405-321-7392
Practice Address - Fax:405-321-7391
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4806122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist