Provider Demographics
NPI:1528311354
Name:BEER, ANDREW SCOTT (DDS)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:SCOTT
Last Name:BEER
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 1:1605 HUNT DR
Mailing Address - Street 2:
Mailing Address - City:NORMAL
Mailing Address - State:IL
Mailing Address - Zip Code:61761-2122
Mailing Address - Country:US
Mailing Address - Phone:309-454-7344
Mailing Address - Fax:309-452-9969
Practice Address - Street 1:1605 HUNT DR
Practice Address - Street 2:
Practice Address - City:NORMAL
Practice Address - State:IL
Practice Address - Zip Code:61761-2122
Practice Address - Country:US
Practice Address - Phone:309-454-7344
Practice Address - Fax:309-452-9969
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-17
Last Update Date:2012-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190291451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice