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General NPI Number Information
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NPI Number | 1770847774
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Entity Type | Individual
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Provider Name | SUZANNE BECK
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Gender | Female
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Dates
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Enumeration Date | 06/25/2012
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Last Update Date | 06/25/2012
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Provider Practice Location Address
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Address Line | 8603 N OAK TRFY
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City | KANSAS CITY
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State | MO
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Zip | 64155-2434
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Country | US
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Telephone | 816-436-8338
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Fax |
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Provider Business Mailing Address
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Address Line | 104 E 28TH TER APT. 4
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City | KANSAS CITY
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State | MO
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Zip | 64108-3355
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Country | US
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Telephone | 636-345-7802
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Fax |
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 2012015441
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License Number State | MO
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