Provider Demographics
NPI:1467502104
Name:BECKER, MARTA (DDS)
Entity Type:Individual
Prefix:
First Name:MARTA
Middle Name:
Last Name:BECKER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33915 1ST WAY S STE 100
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-6396
Mailing Address - Country:US
Mailing Address - Phone:253-517-7780
Mailing Address - Fax:253-517-7810
Practice Address - Street 1:33915 1ST WAY S STE 100
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-6396
Practice Address - Country:US
Practice Address - Phone:253-517-7780
Practice Address - Fax:253-517-7810
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2019-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8827122300000X
WADE602203641223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist