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Individual

DR. BRADLEY DAVID BECKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
3600 OLD GREENWOOD RD, SUITE 2, FORT SMITH, AR 72903-5929
(479) 646-0706
(479) 646-0502
Mailing address
3600 OLD GREENWOOD RD, SUITE 2, FORT SMITH, AR 72903-5929
(479) 646-0706
(479) 646-0502

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3503
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
159196608
AR
Enumeration date
07/22/2008
Last updated
09/08/2008
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