Individual
MRS. ANGELA RENEE BECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS MSD
Contact information
Practice address
4638 W JEFFERSON BLVD, FORT WAYNE, IN 46804-6886
(260) 432-2147
(260) 432-4968
Mailing address
4638 W JEFFERSON BLVD, FORT WAYNE, IN 46804-6886
(260) 432-2147
(260) 432-4968
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
12009655A
IN
Other
Enumeration date
03/06/2007
Last updated
07/08/2007
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