Individual
DOUGLAS JAMES BEAZER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
6526 MAIN ST, BONNERS FERRY, ID 83805-8521
(208) 267-7509
Mailing address
6526 MAIN ST, BONNERS FERRY, ID 83805-8521
(208) 267-7509
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D 3057
ID
Other
Enumeration date
06/24/2009
Last updated
06/24/2009
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