Provider Demographics
NPI:1376687624
Name:BECK, ROBERT P (DDS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:P
Last Name:BECK
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 1:27403 YNEZ RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92591-5603
Mailing Address - Country:US
Mailing Address - Phone:951-676-5607
Mailing Address - Fax:951-676-2566
Practice Address - Street 1:27403 YNEZ RD
Practice Address - Street 2:SUITE 105
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92591-5603
Practice Address - Country:US
Practice Address - Phone:951-676-5607
Practice Address - Fax:951-676-2566
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA214281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice