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Individual
MR. KEN A. BECKERMAN
Active
Individual
MR. KEN A. BECKERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12007838
IN
1223G0001X
General Practice Dentistry
12007838
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1437299989
INDIVIDUAL NPI
IN
Enumeration date
02/07/2007
Last updated
01/24/2017
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