Provider Demographics
NPI:1386711372
Name:BEIER, CHARLES M (DDS, PC)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:M
Last Name:BEIER
Suffix:
Gender:M
Credentials:DDS, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:414 S BEELINE HWY
Mailing Address - Street 2:STE. 5
Mailing Address - City:PAYSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85541-4884
Mailing Address - Country:US
Mailing Address - Phone:928-472-9303
Mailing Address - Fax:928-472-9554
Practice Address - Street 1:414 S BEELINE HWY
Practice Address - Street 2:STE. 5
Practice Address - City:PAYSON
Practice Address - State:AZ
Practice Address - Zip Code:85541-4884
Practice Address - Country:US
Practice Address - Phone:928-472-9303
Practice Address - Fax:928-472-9554
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAZ45951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice