Bethea, Donald Alan

Bethea, Donald Alan is an sole proprietor health care provider with primary practice located at 410 Lister St , Waycross GA 31501-5226. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Bethea, Donald Alan can be contacted via phone (912) 285-1218.

Contact Information

Primary practice address
410 Lister St Waycross GA 31501-5226
Phone: (912) 285-1218
Fax: (912) 285-9518
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X DN011225 Georgia
Dental Providers / Pediatric Dentistry 1223P0221X DS6972 Tennessee

Profile Details

NPI number 1417053646
LBN Legal business name Bethea, Donald Alan
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 15th, 2006
Last updated Jun 18th, 2014 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417053646 NPPES
Georgia MEDICAID 003143408A

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