Individual
MS. SUSAN M BEATTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDA
Contact information
Practice address
1519 S OREGON ST, YREKA, CA 96097-3425
(530) 842-9200
(530) 842-9217
Mailing address
PO BOX 172, FORT JONES, CA 96032-0172
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
59155
CA
Other
Enumeration date
12/06/2006
Last updated
07/08/2007
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