Provider Demographics
NPI:1316055783
Name:BEAL, WILLIAM DAVID (DDS)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:DAVID
Last Name:BEAL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4701 N GALLOWAY AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150-7533
Mailing Address - Country:US
Mailing Address - Phone:972-279-9494
Mailing Address - Fax:972-270-9126
Practice Address - Street 1:4701 N GALLOWAY AVE STE 110
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-7533
Practice Address - Country:US
Practice Address - Phone:972-279-9494
Practice Address - Fax:972-270-9126
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11780122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist