Provider Demographics
NPI:1962581520
Name:BECKMAN, THOMAS MYRON (DDS)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:MYRON
Last Name:BECKMAN
Suffix:
Gender:M
Credentials:DDS
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Mailing Address - Street 1:4675 120TH ST W
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55124-8629
Mailing Address - Country:US
Mailing Address - Phone:952-452-1802
Mailing Address - Fax:612-626-2900
Practice Address - Street 1:515 DELAWARE STREET S.E.
Practice Address - Street 2:6-150 MOOS TOWER - UNIVERSITY OF MINNESOTA
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55455
Practice Address - Country:US
Practice Address - Phone:612-624-2161
Practice Address - Fax:612-626-2900
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MND76581223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry