Individual
DR. NICOLE ELIZABETH BEASLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
100 HEALTH CENTER DR, AHOSKIE, NC 27910-8161
(252) 332-1904
Mailing address
100 HEALTH CENTER DR, AHOSKIE, NC 27910-8161
(252) 332-1904
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
10344
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1447703426
DELTA DENTAL OF NC
NC
05
—
1447703426
—
NC
Enumeration date
07/26/2016
Last updated
02/01/2021
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