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General NPI Number Information
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NPI Number | 1033391230
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Entity Type | Organization
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Legal Business Name | LAWRENCE H. BECK DDS PC
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Dates
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Enumeration Date | 11/29/2007
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Last Update Date | 01/21/2025
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Provider Practice Location Address
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Address Line | 1903 10TH AVE
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City | PORT HURON
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State | MI
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Zip | 48060-3105
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Country | US
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Telephone | 810-985-3200
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Fax | 810-985-3752
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Provider Business Mailing Address
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Address Line | 1903 10TH AVE
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City | PORT HURON
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State | MI
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Zip | 48060-3105
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Country | US
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Telephone | 810-985-3200
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Fax | 810-985-3752
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | AMY RAYNE DAVIS
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Credential |
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Telephone | 810-985-3200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 2901016443
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License Number State | MI
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