Bietsch, Scott Michael

Bietsch, Scott Michael is an individual health care provider with primary practice located at 402 S Lewis Ln , Carbondale IL 62901-3547. He recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / Pediatric Dentistry. Dental Providers / Dentist is his primary health care specialty. Bietsch, Scott Michael can be contacted via phone (618) 519-9200.

Contact Information

Primary practice address
402 S Lewis Ln Carbondale IL 62901-3547
Phone: (618) 519-9200
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 019.028399 Illinois
Dental Providers / Pediatric Dentistry 1223P0221X 021002781 Illinois

Profile Details

NPI number 1902119837
LBN Legal business name Bietsch, Scott Michael
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 20th, 2010
Last updated Dec 9th, 2016 - about 9 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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