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General NPI Number Information
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NPI Number | 1336561588
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Entity Type | Individual
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Provider Name | SANDY BECKETT
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Gender | Female
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Dates
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Enumeration Date | 01/07/2014
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Last Update Date | 01/07/2014
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Provider Practice Location Address
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Address Line | 456 E HANCOCK ST
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City | LANSDALE
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State | PA
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Zip | 19446-3803
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Country | US
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Telephone | 215-855-7717
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Fax | 215-368-0937
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Provider Business Mailing Address
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Address Line | 456 E HANCOCK ST
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City | LANSDALE
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State | PA
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Zip | 19446-3803
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Country | US
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Telephone | 215-855-7717
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Fax | 215-368-0937
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DS-029884-L
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License Number State | PA
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