Individual
ROBERT W. BEAVERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
102 N MAIN ST, BEEBE, AR 72012-3046
(501) 882-5491
(501) 885-5271
Mailing address
102 N MAIN ST, BEEBE, AR 72012-3046
(501) 882-5491
(501) 885-5271
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
AR3214
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5T649
BCBS PROVIDER I.D.
AR
01
—
971125
UNITEDCONCORDIA PROVIDER
AR
Enumeration date
07/31/2006
Last updated
07/09/2007
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