Individual
DR. JENNIFER LYNN BEAVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D
Contact information
Practice address
1976 DOUGLASS BLVD, LOUISVILLE, KY 40205-1826
(502) 454-7627
(502) 384-8203
Mailing address
814 FETTER AVE, LOUISVILLE, KY 40217-2233
(502) 724-0397
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
12011286A
IN
1223G0001X
General Practice Dentistry
Primary
8632
KY
1223G0001X
General Practice Dentistry
DS0000008818
TN
Other
Enumeration date
10/26/2008
Last updated
01/25/2013
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