Provider Demographics
NPI:1649794983
Name:BECKER, HANNAH CLAIRE (DDS)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:CLAIRE
Last Name:BECKER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4410 ALEXIS RD.
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43567
Mailing Address - Country:US
Mailing Address - Phone:419-473-9450
Mailing Address - Fax:
Practice Address - Street 1:327 BUCKEYE BLVD.
Practice Address - Street 2:
Practice Address - City:PORT CLINTON
Practice Address - State:OH
Practice Address - Zip Code:43452
Practice Address - Country:US
Practice Address - Phone:419-734-5574
Practice Address - Fax:419-734-9884
Is Sole Proprietor?:No
Enumeration Date:2017-07-28
Last Update Date:2017-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0251461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice