# DR. TIMOTHY ALAN BETITA

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1265726897
- **Gender:** Man
- **Credential:** MD, DDS

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 30090 | TX | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 9811800-9921 | UT | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | A151709 | CA | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | DDS101214 | CA | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | DENT.DE.60660678 | WA | — |

## Other

- **Enumeration date:** 05/31/2011
- **Last updated:** 04/16/2019