Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. BEAU JOHN BRASSEALE, D.D.S., M.S.D.
ActiveDR. BEAU JOHN BRASSEALE, D.D.S., M.S.D. is a Endodontics healthcare provider located in BOWLING GREEN, Kentucky. NPI 1689836439 is currently active in the NPPES registry. Verify at CMS.
Endodontics · BOWLING GREEN, KY
Registration Details
- NPI Number
- 1689836439
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jul 1, 2008 (18.08851829864 yrs)
- Last Updated
- Oct 14, 2011
- Licenses
-
12011193A (IN)9102 (KY)
Practice Information
- Address
-
901 WILKINSON TRCESUITE #2BOWLING GREEN, KY, 421032483Browse KY providers · Browse ZIP 42103
- Phone
- 2709044404
- Primary Specialty
-
Endodontics
1223E0200X
- Additional Specialty
- Endodontics
Other Endodontics Providers in BOWLING GREEN, KY
| Name | Credential | NPI |
|---|---|---|
| SAMANTHA JO JOHNSON | — | 1083971956 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.