Organization
BECKER BORIS P DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BORIS BECKER DDS (OWNER)
(847) 622-0400
Entity
Organization
Contact information
Practice address
214 RANDALL RD, SOUTH ELGIN, IL 60177-2274
(847) 622-0400
(847) 622-7818
Mailing address
214 RANDALL RD, SOUTH ELGIN, IL 60177-2274
(847) 622-0400
(847) 622-7818
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019025213
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1004729
—
IL
Enumeration date
07/29/2008
Last updated
07/29/2008
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