Provider Demographics
NPI:1811052111
Name:BEELER, MICHELE F (DMD)
Entity type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:F
Last Name:BEELER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 WHIPP AVE.
Mailing Address - Street 2:P. O. BOX 1166
Mailing Address - City:LIBERTY
Mailing Address - State:KY
Mailing Address - Zip Code:42539
Mailing Address - Country:US
Mailing Address - Phone:606-787-5222
Mailing Address - Fax:606-787-9599
Practice Address - Street 1:650 WHIPP AVE.
Practice Address - Street 2:
Practice Address - City:LIBERTY
Practice Address - State:KY
Practice Address - Zip Code:42539
Practice Address - Country:US
Practice Address - Phone:606-787-5222
Practice Address - Fax:606-787-9599
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY69181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice