Provider Demographics
NPI:1174060883
Name:KIMBALL & BEECHER CEDAR RAPIDS, PLLC
Entity type:Organization
Organization Name:KIMBALL & BEECHER CEDAR RAPIDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:BEAU
Authorized Official - Middle Name:
Authorized Official - Last Name:BEECHER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:319-235-6287
Mailing Address - Street 1:2120 WESTDALE DR SW
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52404-6318
Mailing Address - Country:US
Mailing Address - Phone:319-396-5336
Mailing Address - Fax:319-396-4576
Practice Address - Street 1:4015 HURST DR
Practice Address - Street 2:
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50701-9035
Practice Address - Country:US
Practice Address - Phone:319-235-6287
Practice Address - Fax:319-232-3171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-20
Last Update Date:2017-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty