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Organization

BEW ENTERPRISES, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BRADLEY EMMETT WILLIAMS (OWNER)
(601) 854-5001
Entity
Organization

Contact information

Practice address
105 N BROOKS ST, PELAHATCHIE, MS 39145-3091
(601) 854-5001
(601) 854-6198
Mailing address
105 N BROOKS ST, PELAHATCHIE, MS 39145-3091
(601) 854-5001
(601) 854-6198

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
269896
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00060471
MS
05
00660353
MS
05
04400322
MS
Enumeration date
03/10/2009
Last updated
03/10/2009
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