Individual
STEPHEN M BEETSTRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1581 DODD DR., MCCAMPBELL HALL -RM. 345, COLUMBUS, OH 43210-4321
(614) 685-3197
(614) 685-3212
Mailing address
1581 DODD DR., MCCAMPBELL HALL RM. 345, COLUMBUS, OH 43210-1257
(614) 685-3197
(614) 685-3212
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
30026044
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0411082
—
OH
Enumeration date
08/12/2006
Last updated
03/16/2022
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