Provider Demographics
NPI:1144322272
Name:BEEMAN, TED MARVIN (DDS)
Entity type:Individual
Prefix:MR
First Name:TED
Middle Name:MARVIN
Last Name:BEEMAN
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 1:2306 W 50TH ST
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55410
Mailing Address - Country:US
Mailing Address - Phone:612-920-2075
Mailing Address - Fax:612-920-5296
Practice Address - Street 1:2306 W 50TH ST
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55410
Practice Address - Country:US
Practice Address - Phone:612-920-2075
Practice Address - Fax:612-920-5296
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN7788122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist