Organization
MICHAEL W BEASLEY DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICKI LEE BEASLEY (OPERATION MANAGER)
(719) 216-2054
Entity
Organization
Contact information
Practice address
6475 WALL ST STE 202, COLORADO SPRINGS, CO 80918-8341
(719) 216-2054
Mailing address
6475 WALL ST STE 202, COLORADO SPRINGS, CO 80918-8341
(719) 216-2054
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
6670
CO
Other
Enumeration date
07/17/2013
Last updated
07/17/2013
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