Organization
LIGHTHOUSE DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRUCE F BECKER DDS (PRESIDENT)
(574) 936-3921
Entity
Organization
Contact information
Practice address
556 N OAK RD, PLYMOUTH, IN 46563-1664
(574) 936-3921
(574) 936-1010
Mailing address
556 N OAK RD, PLYMOUTH, IN 46563-1664
(574) 936-3921
(574) 936-1010
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12009200
IN
Other
Enumeration date
07/17/2006
Last updated
11/20/2007
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