Individual
DR. GREGG W. BEATY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
3737 MORAGA AVE, SUITE B-200, SAN DIEGO, CA 92117-5404
(858) 272-7086
(858) 272-7289
Mailing address
3737 MORAGA AVE, SUITE B-200, SAN DIEGO, CA 92117-5404
(858) 272-7086
(858) 272-7289
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
034467
CA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
4036-015
WI
Other
Enumeration date
11/10/2006
Last updated
07/08/2007
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