Individual
DR. TED MICHAEL BEAUCHAMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
853 MEDICAL DR STE 112, WENTZVILLE, MO 63385-3825
(636) 487-0122
Mailing address
853 MEDICAL DR STE 112, WENTZVILLE, MO 63385-3825
(636) 487-0122
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
2009013186
MO
1223E0200X
Endodontics
Primary
2009013186
MO
Other
Enumeration date
07/31/2009
Last updated
12/18/2023
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