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| Type | Company | [sources] | |||
|---|---|---|---|---|---|
| Name | Beaver Dental Associates, LLC | [sources] | |||
| Incorporation date | not available | [sources] | |||
| Jurisdiction | not available | [sources] | |||
| Country | United States | [sources] | |||
| NPI | 1215178785 | [sources] | |||
| Registration number | not available | [sources] | |||
| Address | PA, PA | [sources] | |||
| Last change | Last processed | First seen | |||
Medical providers who are precluded from participation in the Medical Assistance Program
United States · DHS
For experts: raw data explorer
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| Address | ||
|---|---|---|
| Full address | Country | |
| PA, PA | United States | |
| Linked from | ||||
|---|---|---|---|---|
| Subject | Role | Start date | End date | |
| Jacqueline A Ingram Debarred entity | - | - | - | |