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Individual

DR. WILLIS TILMON BEENE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
615 N. JACKSON ST., MAGNOLIA, AR 71754
(870) 234-1110
(870) 234-1112
Mailing address
P.O. BOX 1133, 615 N. JACKSON ST., MAGNOLIA, AR 71754
(870) 234-1110
(870) 234-1112

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2106
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
101570608
AR
Enumeration date
08/28/2006
Last updated
02/17/2010
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