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Contact Information

KENNETH C BEAL JR, DDS
913 B.B. KING ROAD
INDIANOLA, MS38751
 Phone: 662-887-4814
 Fax: 662-887-9418
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for KENNETH C BEAL JR · (Male)

NPI Number 1649463977
Status Active
Credentials DDS (Doctor of Dental Surgery)
Entity Individual
Enumeration date 08/21/2007
Last updated 08/21/2007 - About 19 years ago
Sole proprietor 1 Yes
Identifiers
  • MS License # 2459-89
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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