Provider Demographics
NPI:1497981104
Name:BECK, JARED CAMERON (DMD)
Entity Type:Individual
Prefix:DR
First Name:JARED
Middle Name:CAMERON
Last Name:BECK
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6266 COBBLECREST RD
Mailing Address - Street 2:
Mailing Address - City:HOLLADAY
Mailing Address - State:UT
Mailing Address - Zip Code:84121-2218
Mailing Address - Country:US
Mailing Address - Phone:801-274-0599
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY HOSPITAL
Practice Address - Street 2:26 SOUTH 2000 EAST, SUITE 5900
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84112-5750
Practice Address - Country:US
Practice Address - Phone:801-581-8951
Practice Address - Fax:801-585-6485
Is Sole Proprietor?:No
Enumeration Date:2009-06-09
Last Update Date:2009-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program