Organization
COURTNEY L BEUSSINK DDS LLC
Active
Other names
First STreet Smiles
Organization subpart
No
Provider details
NPI number
Authorized official
DR. COURTNEY L BEUSSINK DDS (DENTIST/OWNER)
(573) 238-3330
Entity
Organization
Contact information
Practice address
103 N FIRST ST, MARBLE HILL, MO 63764
(573) 238-3330
(573) 238-3464
Mailing address
PO BOX 650, MARBLE HILL, MO 63764-0650
(573) 238-3330
(573) 238-3464
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2010016160
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1023338860
NPI
MO
01
—
1861580532
NPI
—
Enumeration date
03/19/2014
Last updated
03/19/2014
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