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Individual

ROGER DUANE BECK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
3470 E MERIDIAN PARK LOOP, WASILLA, AK 99654-7294
(907) 373-8684
(907) 373-8465
Mailing address
3470 E MERIDIAN PARK LOOP, WASILLA, AK 99654-7294
(907) 373-8684
(907) 373-8465

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
101
AK
1223P0221X
Pediatric Dentistry
Primary
924
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1003811
AK
Enumeration date
03/24/2007
Last updated
01/14/2014
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