Beard, Avery Brooke

Beard, Avery Brooke is an individual health care provider with primary practice located at 13121 E 21St St N Ste 107 , Wichita KS 67230-7403. She recently has only one registered license in Dental Providers / Dentist, which is considered as her primary health care specialty. Beard, Avery Brooke can be contacted via phone (316) 630-9500.

Contact Information

Primary practice address
13121 E 21St St N Ste 107 Wichita KS 67230-7403
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 62661 Kansas

Profile Details

NPI number 1043871445
LBN Legal business name Beard, Avery Brooke
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 26th, 2019
Last updated Jun 26th, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043871445 NPPES
Kansas Other 62661 DENTAL LICENSE

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