MEDICARE: DR. BRUCE FARRELL BECKER DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	12009200	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770745374
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRUCE FARRELL BECKER DDS

Provider Business Mailing Address
First Line	:	556 N OAK ROAD
Second Line	:	LIGHT HOUSE DENTAL
City	:	PLYMOUTH
State	:	IN
Zip	:	46563-1664
Country	:	US
Telephone Number	:	574-936-3921
Fax Number	:	574-936-1010

Provider Business Practice Location Address
First Line	:	556 N OAK ROAD
Second Line	:	LIGHT HOUSE DENTAL
City	:	PLYMOUTH
State	:	IN
Zip	:	46563-1664
Country	:	US
Telephone Number	:	574-936-3921
Fax Number	:	574-936-1010

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/26/2008
Last Update Date	:	06/26/2008

Similar Medicare Providers

1861410318 — LIGHTHOUSE DENTAL
Practice Location Address:

556 N OAK RD
PLYMOUTH, IN
46563-1664

Practice Phone: 574-936-3921
Practice Fax: 574-936-1010

1154798262 — MARK JUREK
Practice Location Address:

556 N OAK DR
PLYMOUTH, IN
46563-1664

Practice Phone: 574-936-3921
Practice Fax:

1821451386 — ALVIN NEIL HUNTER
Practice Location Address:

568 N OAK DR
PLYMOUTH, IN
46563-1664

Practice Phone: 574-540-2526
Practice Fax:

1871073775 — DR. ZACHARY RENE VANDEVOORDE DMD
Practice Location Address:

556 N OAK DR
PLYMOUTH, IN
46563-1664

Practice Phone: 574-936-3921
Practice Fax: 574-936-1010

1174170393 — JEAS HUNTER LLC
Practice Location Address:

568 N OAK DR
PLYMOUTH, IN
46563-1664

Practice Phone: 574-540-2526
Practice Fax:

1891993069 — DAVID SILVERMAN PT
Practice Location Address:

10-08 PLYMOUTH DR
FAIR LAWN, NJ
07410-1664

Practice Phone: 800-950-6066
Practice Fax:

Directions to “ DR. BRUCE FARRELL BECKER DDS” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.