Beavers, Nathan Keil
Beavers, Nathan Keil is an individual health care provider with primary practice located at 312 Fountains Drive , Madison MS 39110. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Beavers, Nathan Keil can be contacted via phone (601) 856-5313.Contact Information
Primary practice address
312 Fountains Drive
Madison MS 39110
Phone: (601) 856-5313
Fax: (601) 856-5552
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Pediatric Dentistry | 1223P0221X | PEDO 377-04 | Mississippi |
Profile Details
| NPI number | 1790849404 |
|---|---|
| LBN Legal business name | Beavers, Nathan Keil |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 20th, 2006 |
| Last updated | Oct 13th, 2021 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1790849404 | NPPES |
| Mississippi | MEDICAID | 08101262 |
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