Provider Demographics
NPI:1245415777
Name:BECHARD, DEAN (DC)
Entity type:Individual
Prefix:DR
First Name:DEAN
Middle Name:
Last Name:BECHARD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11225 COMMERCE DR N
Mailing Address - Street 2:
Mailing Address - City:CHAMPLIN
Mailing Address - State:MN
Mailing Address - Zip Code:55316-3122
Mailing Address - Country:US
Mailing Address - Phone:763-421-8588
Mailing Address - Fax:
Practice Address - Street 1:11225 COMMERCE DR N
Practice Address - Street 2:
Practice Address - City:CHAMPLIN
Practice Address - State:MN
Practice Address - Zip Code:55316-3122
Practice Address - Country:US
Practice Address - Phone:763-421-8588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-03
Last Update Date:2019-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2152111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN090828200Medicaid
MN350001827Medicare PIN