Healthcare Provider Details

I. General information

NPI: 1700836103
Provider Name (Legal Business Name): WILLIAM D BECK D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4252 S LINDEN RD
FLINT MI
48507-2953
US

IV. Provider business mailing address

4252 S LINDEN RD
FLINT MI
48507-2953
US

V. Phone/Fax

Practice location:
  • Phone: 810-733-1890
  • Fax: 810-733-3619
Mailing address:
  • Phone: 810-733-1890
  • Fax: 810-733-3619

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number9725
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: