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Individual

JONATHAN AVERY BECK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
114 W 11TH STREET, SILVER CITY, NM 88061-5136
(575) 388-1511
Mailing address
530 DEMOSS STREET, LORDSBURG, NM 88045-2618
(575) 542-8384

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DD3675
NM

Other

Enumeration date
06/19/2012
Last updated
06/19/2012
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