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Individual

DR. BRANDON E BEAVER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
2915 WESTSIDE DR, DURANT, OK 74701-2028
(580) 924-1234
(580) 920-2082
Mailing address
2915 WESTSIDE DR, DURANT, OK 74701-2028
(580) 924-1234
(580) 920-2082

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5597
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200045860A
OK
Enumeration date
07/11/2006
Last updated
07/25/2012
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