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Individual

DR. LYNNEL CONSTANCE DICKSON BEAUCHESNE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
D.D.S.

Contact information

Practice address
RR 2 BOX 181-23, TUNNELTON, WV 26444-9642
(304) 892-4653
(304) 892-3943
Mailing address
RR 2 BOX 181-23, TUNNELTON, WV 26444-9642
(304) 892-4653
(304) 892-3943

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3317
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0134475000
WV
01
3317
LICENSE
WV
Enumeration date
04/17/2007
Last updated
07/08/2007
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