Provider Demographics
NPI:1750447751
Name:BECK, JANELL JUNE
Entity Type:Individual
Prefix:DR
First Name:JANELL
Middle Name:JUNE
Last Name:BECK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LENNOX
Mailing Address - State:SD
Mailing Address - Zip Code:57039-0663
Mailing Address - Country:US
Mailing Address - Phone:605-647-2881
Mailing Address - Fax:605-647-2881
Practice Address - Street 1:101 SO MAIN ST
Practice Address - Street 2:
Practice Address - City:LENNOX
Practice Address - State:SD
Practice Address - Zip Code:57039-0663
Practice Address - Country:US
Practice Address - Phone:605-647-2881
Practice Address - Fax:605-647-2881
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDM4721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice