Individual
MEGAN BECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MDT
Contact information
Practice address
12936 63RD AVE N, MAPLE GROVE, MN 55369-6001
(763) 559-3400
Mailing address
8196 SHADYVIEW LN N, MAPLE GROVE, MN 55311-1700
(763) 913-9441
Taxonomy
Speciality
Code
Description
License number
State
125J00000X
Dental Therapist
Primary
DT58
MN
Other
Enumeration date
05/08/2015
Last updated
05/08/2015
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