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Dr. Nathan Keil Beavers, DMD
Pediatric Dentist in Madison, Mississippi
NPI 1790849404

Nathan Keil Beavers is a Pediatric Dentist based in Madison, MS and is specialized in Pediatric Dentistry. Nathan Keil Beavers practices in Madison, MS and has the professional credentials of DMD. The NPI Number for Nathan Keil Beavers is 1790849404 and holds a License No. PEDO 377-04 (Mississippi).

The current practice location address for Nathan Keil Beavers is 312 Fountains Drive, Madison, MS and can be reached out via phone at 601-856-5313 and via fax at 601-856-5552.

Location: 312 Fountains Drive, Madison, MS, 39110-6322
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1790849404
Provider Name
Nathan Keil Beavers
Credential
DMD
Provider Entity Type
Individual
Gender
Male
Address
312 Fountains Drive, Madison, MS, 39110-6322
Phone Number
601-856-5313
Fax Number
601-856-5552
Provider Enumeration Date
12/20/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
08101262 05 MS
institution
Provider Business Practice Location Address Details
Address
312 Fountains Drive
City
Madison
State
Mississippi
Zip
39110
Phone Number
601-856-5313
Fax Number
601-856-5552
person
Provider Business Mailing Address Details
Address
312 Fountains Drive
City
Madison
State
Mississippi
Zip
39110
Phone Number
601-856-5313
Fax Number
601-856-5552
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Pediatric Dentistry
Taxonomy
1223P0221X
License No.
PEDO 377-04 (Mississippi)
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
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