Provider Demographics
NPI:1174619746
Name:BESHEARS, RONALD RAY (DDS)
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:RAY
Last Name:BESHEARS
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 1:720 WEST MAIN STREET
Mailing Address - Street 2:SUITE B
Mailing Address - City:JAMESTOWN
Mailing Address - State:NC
Mailing Address - Zip Code:27282
Mailing Address - Country:US
Mailing Address - Phone:336-454-6163
Mailing Address - Fax:336-889-5353
Practice Address - Street 1:720 WEST MAIN STREET
Practice Address - Street 2:SUITE B
Practice Address - City:JAMESTOWN
Practice Address - State:NC
Practice Address - Zip Code:27282
Practice Address - Country:US
Practice Address - Phone:336-454-6163
Practice Address - Fax:336-889-5353
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC36461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice