Individual
DR. RYAN BEETHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
US ARMY DENTAC, 9900 LINCOLN STREET, 2ND FLOOR, TACOMA, WA 98327
(253) 968-4079
Mailing address
9900 LINCOLN STREET, 2ND FLOOR, ATTN: CREDENTIAL OFFICE, US ARMY DENTAC, TACOMA, WA 98327
(253) 968-4079
(253) 968-5919
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/18/2019
Last updated
07/18/2019
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