Individual
DR. ALEXANDER BEAVERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
403 LOCUST ST, CARROLLTON, IL 62016-1304
(217) 942-6964
Mailing address
403 LOCUST ST, CARROLLTON, IL 62016-1304
(217) 942-6964
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019030499
IL
Other
Enumeration date
10/14/2015
Last updated
10/14/2015
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