Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122400000X | Denturist | 4946 | NE |
NPI | 1790860849 |
---|---|
Provider Name | Dr. Marcia K. Beck |
First Address | Omaha, NE 68154-5241 |
Second Address | Omaha, NE 68154-5241 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/10/2006 |
Last Update Date | 08/07/2007 |