Individual
DR. RANDY CARL BEARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
113 MAIN ST S, CLEARBROOK, MN 56634-0314
(218) 776-3558
(218) 776-2112
Mailing address
113 MAIN ST S, PO BOX 314, CLEARBROOK, MN 56634-0314
(218) 776-3558
(218) 776-2112
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
10180
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
35768 BE
BLUE CROSS BLUE SHIELD ID
MN
Enumeration date
10/12/2006
Last updated
07/08/2007
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