DR. Virgil A Beadle, DDX

NPI #1609943091 in Carbondale, Illinois

Provider Information

NPI Number: 1609943091
Entity Type: Individual
Name: DR. Virgil A Beadle, DDX
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Credential: DDX
Enumeration Date: Nov 29, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: #4 CROWN LANE
City: Carbondale
State: Illinois
ZIP Code: 62903-7604
Phone: (618) 457-4137

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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