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Organization

KENNETH E. BEARD, DDS,PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KENNETH E BEARD DDS (PRESIDENT)
(423) 476-6541
Entity
Organization

Contact information

Practice address
415 25TH ST NW, CLEVELAND, TN 37311-3892
(423) 476-6541
(423) 472-7719
Mailing address
415 25TH ST NW, CLEVELAND, TN 37311-3892
(423) 476-6541
(423) 472-7719

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2223
TN
332BC3200X
Customized Equipment (DME)

Other

Enumeration date
11/05/2012
Last updated
11/05/2012
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