Provider Demographics
NPI:1639272529
Name:BECKER, RAY MARTIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:RAY
Middle Name:MARTIN
Last Name:BECKER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8894 STANFORD BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-5162
Mailing Address - Country:US
Mailing Address - Phone:410-730-4674
Mailing Address - Fax:410-541-1080
Practice Address - Street 1:8894 STANFORD BLVD STE 200
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-5162
Practice Address - Country:US
Practice Address - Phone:410-730-4674
Practice Address - Fax:410-730-5374
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-06
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD94941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice