Individual
CLAY ALLEN BESHORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
4621 W 6TH ST STE B, LAWRENCE, KS 66049-4358
(785) 856-8550
Mailing address
4621 W 6TH ST STE B, LAWRENCE, KS 66049-4358
(785) 856-8550
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6588
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
116585
BCBS OF KANSAS PROVIDER
KS
05
—
200306700A
—
KS
01
—
481217182
DELTA DENTAL OF KANSAS PR
KS
Enumeration date
11/16/2005
Last updated
10/07/2020
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