Individual
JUSTIN FORD BECERRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2323 S WADSWORTH BLVD STE 1778, LAKEWOOD, CO 80227-3274
(303) 980-4800
Mailing address
11332 CENTRAL CT, APT 15209, BROOMFIELD, CO 80021-5045
(808) 979-4771
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
00202851
CO
1223G0001X
General Practice Dentistry
Primary
DEN.00202851
CO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003540281
DRIVERS LICENSE
CO
Enumeration date
02/17/2016
Last updated
11/19/2019
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