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General NPI Number Information
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NPI Number | 1093596637
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Entity Type | Organization
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Legal Business Name | BECK PASSAMANO DENTAL GROUP
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Dates
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Enumeration Date | 10/10/2023
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Last Update Date | 10/10/2023
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Provider Practice Location Address
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Address Line | 14982 SAND CANYON AVE
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City | IRVINE
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State | CA
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Zip | 92618-2106
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Country | US
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Telephone | 949-396-3803
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Fax | 949-572-7708
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Provider Business Mailing Address
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Address Line | 14982 SAND CANYON AVE
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City | IRVINE
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State | CA
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Zip | 92618-2106
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Country | US
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Telephone | 949-396-3803
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Fax |
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | MELINDA BECK
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Credential | DDS
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Telephone | 949-396-3803
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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