Provider Demographics
NPI:1043316557
Name:BECKFORD, ANDREA R (DDS)
Entity type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:R
Last Name:BECKFORD
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:9045 US HIGHWAY 31 STE 1
Mailing Address - Street 2:
Mailing Address - City:BERRIEN SPRINGS
Mailing Address - State:MI
Mailing Address - Zip Code:49103-1804
Mailing Address - Country:US
Mailing Address - Phone:269-471-5244
Mailing Address - Fax:269-471-9232
Practice Address - Street 1:9045 US HIGHWAY 31
Practice Address - Street 2:
Practice Address - City:BERRIEN SPRINGS
Practice Address - State:MI
Practice Address - Zip Code:49103-1804
Practice Address - Country:US
Practice Address - Phone:989-533-1888
Practice Address - Fax:269-471-9232
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GU1023122300000X
MI2901022137122300000X
IN12013410A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist