Individual
LEAH G BEAVERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
619 W CHATHAM ST, APEX, NC 27502-1415
(919) 362-0967
(919) 355-1551
Mailing address
619 W CHATHAM ST, APEX, NC 27502-1415
(919) 362-0967
(919) 355-1551
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5601
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1651885
UNITED CONCORDIA
—
05
—
1856011
—
LA
Enumeration date
04/06/2006
Last updated
05/21/2008
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