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NPI 1992889588

NPI 1992889588 : DAVID J BETZ DDS : JONESVILLE, MI

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General NPI Number Information
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    NPI Number           |    1992889588
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    Entity Type          |    Individual 
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    Provider Name        |    DAVID J BETZ DDS
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    10/24/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    211 HARLEY 
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    City                 |    JONESVILLE
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    State                |    MI
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    Zip                  |    49250
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    Country              |    US
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    Telephone            |    517-849-2411
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    Fax                  |    517-849-2418
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Provider Business Mailing Address
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    Address Line         |    PO BOX 172 
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    City                 |    JONESVILLE
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    State                |    MI
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    Zip                  |    49250
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    Country              |    US
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    Telephone            |    517-849-2411
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    Fax                  |    517-849-2418
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1223G0001X
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    Taxonomy Name        |    General Practice Dentistry
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    License Number       |    2901012454
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    License Number State |    MI
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