# NATHAN K. BEAVERS DMD PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Beavers Pediatric Dentistry
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003138967
- **Authorized official:** ANNE MARIE CURRIE HREISH DDS (DENTIST)
- **Authorized official phone:** (601) 856-5313

## Contact information

- **Practice address:** 312 FOUNTAINS DR, MADISON, MS 39110-6384
- **Practice address phone:** (601) 856-5313
- **Practice address fax:** (601) 856-5552
- **Mailing address:** 312 FOUNTAINS DR, MADISON, MS 39110-6384
- **Mailing address phone:** (601) 856-5313
- **Mailing address fax:** (601) 856-5552

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0221X | Pediatric Dentistry | — | NULL | Yes |
| 1223P0221X | Pediatric Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 02/19/2010
- **Last updated:** 11/25/2025