Provider Demographics
NPI:1740374537
Name:BECK, WILLIAM LENON (DMD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:LENON
Last Name:BECK
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6555 SUGARLOAF PKWY
Mailing Address - Street 2:SUITE 308
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30097-4930
Mailing Address - Country:US
Mailing Address - Phone:678-474-0777
Mailing Address - Fax:678-474-0880
Practice Address - Street 1:6555 SUGARLOAF PKWY
Practice Address - Street 2:SUITE 308
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30097-4930
Practice Address - Country:US
Practice Address - Phone:678-474-0777
Practice Address - Fax:678-474-0880
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA97911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice