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Individual

JODI BECKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
636 BROADWAY ST NE, MINNEAPOLIS, MN 55413-2164
(612) 746-1530
Mailing address
3014 179TH AVE NW, ANDOVER, MN 55304-1231
(612) 802-3428

Taxonomy

Speciality
Code
Description
License number
State
125J00000X
Dental Therapist
Primary
DT49
MN

Other

Enumeration date
07/24/2014
Last updated
07/24/2014
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