# DR. LYNNEL CONSTANCE DICKSON BEAUCHESNE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1376769455
- **Gender:** F
- **Credential:** D.D.S.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 3317 | WV | Yes |

## Other

- **Enumeration date:** 04/17/2007
- **Last updated:** 07/08/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0134475000 | — | WV |
| 01 | — | 3317 | LICENSE | WV |