Organization
PHILLIP D. BEAVER, DDS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PHILLIP DANIEL BEAVER D.D.S. (PRESIDENT)
(704) 872-8934
Entity
Organization
Contact information
Practice address
1209 DAVIE AVE, STATESVILLE, NC 28677-3511
(704) 872-8934
Mailing address
1209 DAVIE AVE, STATESVILLE, NC 28677-3511
(704) 872-8934
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8056
NC
Other
Enumeration date
03/09/2010
Last updated
03/09/2010
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