Provider Demographics
NPI:1336176932
Name:BECKER, RALPH J (DDS)
Entity Type:Individual
Prefix:DR
First Name:RALPH
Middle Name:J
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 1:7007 DAVISON RD
Mailing Address - Street 2:
Mailing Address - City:DAVISON
Mailing Address - State:MI
Mailing Address - Zip Code:48423
Mailing Address - Country:US
Mailing Address - Phone:810-658-9177
Mailing Address - Fax:810-658-9166
Practice Address - Street 1:7007 DAVISON RD
Practice Address - Street 2:
Practice Address - City:DAVISON
Practice Address - State:MI
Practice Address - Zip Code:48423
Practice Address - Country:US
Practice Address - Phone:810-658-9177
Practice Address - Fax:810-658-9166
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI0145261223G0001X
MI29010217231223G0001X
MI29010146261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice