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Individual

DR. CHAD LAURENT BEATTY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD. MD

Contact information

Practice address
555 DELAWARE ST, TONAWANDA, NY 14150-5358
(716) 694-1134
(716) 694-0665
Mailing address
8190 OAKLEAF LANE, WILLIAMSVILLE, NY 14221
(716) 636-1530

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
050022
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00026001505
UNIVERA
NY
01
000527196004
BC/BS COMMUNITY BLUE
NY
05
02364661
NY
Enumeration date
09/07/2006
Last updated
07/08/2007
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