Provider Demographics
NPI:1033368006
Name:BECK, STEPHEN DAVID (DMD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:DAVID
Last Name:BECK
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1501 REGENTS BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:FIRCREST
Mailing Address - State:WA
Mailing Address - Zip Code:98466-6098
Mailing Address - Country:US
Mailing Address - Phone:253-564-2222
Mailing Address - Fax:253-460-1446
Practice Address - Street 1:1501 REGENTS BLVD STE 200
Practice Address - Street 2:
Practice Address - City:FIRCREST
Practice Address - State:WA
Practice Address - Zip Code:98466-6098
Practice Address - Country:US
Practice Address - Phone:253-564-2222
Practice Address - Fax:253-460-1446
Is Sole Proprietor?:No
Enumeration Date:2008-09-15
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE601408201223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry