Provider Demographics
NPI:1023008307
Name:BECKER, CLIFFORD IRVING (DDS)
Entity Type:Individual
Prefix:DR
First Name:CLIFFORD
Middle Name:IRVING
Last Name:BECKER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:CLIFFORD
Other - Middle Name:
Other - Last Name:BECKER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:2815 OCEAN PKWY
Mailing Address - Street 2:L1
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-7839
Mailing Address - Country:US
Mailing Address - Phone:718-648-4100
Mailing Address - Fax:
Practice Address - Street 1:2815 OCEAN PKWY
Practice Address - Street 2:L1
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-7839
Practice Address - Country:US
Practice Address - Phone:718-648-4100
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY238061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice