Provider Demographics
NPI:1902966617
Name:KEITH M BEVER DDS MS PC
Entity Type:Organization
Organization Name:KEITH M BEVER DDS MS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR.
Authorized Official - Prefix:DR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:MARTIN
Authorized Official - Last Name:BEVER
Authorized Official - Suffix:SR
Authorized Official - Credentials:DDS
Authorized Official - Phone:989-463-2400
Mailing Address - Street 1:317 E WARWICK DR
Mailing Address - Street 2:
Mailing Address - City:ALMA
Mailing Address - State:MI
Mailing Address - Zip Code:48801
Mailing Address - Country:US
Mailing Address - Phone:989-463-2400
Mailing Address - Fax:989-463-2726
Practice Address - Street 1:317 E WARWICK DR
Practice Address - Street 2:
Practice Address - City:ALMA
Practice Address - State:MI
Practice Address - Zip Code:48801-1085
Practice Address - Country:US
Practice Address - Phone:989-463-2400
Practice Address - Fax:989-463-2726
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2009-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI95241223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty