Provider Demographics
NPI:1275818791
Name:BECKER, RYAN ANDREW (DMD, MS)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:ANDREW
Last Name:BECKER
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Gender:M
Credentials:DMD, MS
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Mailing Address - Street 1:1288 VALLEY FORGE RD
Mailing Address - Street 2:SUITE 60
Mailing Address - City:PHOENIXVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19460-2687
Mailing Address - Country:US
Mailing Address - Phone:610-935-1547
Mailing Address - Fax:610-935-7630
Practice Address - Street 1:1288 VALLEY FORGE RD
Practice Address - Street 2:SUITE 60
Practice Address - City:PHOENIXVILLE
Practice Address - State:PA
Practice Address - Zip Code:19460-2687
Practice Address - Country:US
Practice Address - Phone:610-935-1547
Practice Address - Fax:610-935-7630
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-16
Last Update Date:2011-10-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PADS0386241223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics