Donald A. Bethea, D.D.S., L.L.C.
Dentist, Pediatric Dentistry in Waycross, GA. Organization (NPI-2).
NPI number1124432166
StatusActive
Last updated in NPPESJun 18, 2014
Details
- NPI
- 1124432166
- Entity type
- Organization (NPI-2)
- Legal business name
- Donald A. Bethea, D.D.S., L.L.C.
- Organization subpart
- No
- Enumeration date
- Jun 18, 2014
- Last updated
- Jun 18, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223P0221X | Dentist, Pediatric Dentistry | DN011225 | GA | Yes |
Practice location
410 Lister StWaycross, GA 31501-5226
Phone 912-285-1218
Mailing address
410 Lister StWaycross, GA 31501-5226
Phone 912-285-1218
Authorized official
Donald Alan Bethea
Denitst/Owner
9122851218
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