Organization
JOHN H BETZ DDS SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN H BETZ DDS (SC PRES)
(608) 782-4054
Entity
Organization
Contact information
Practice address
615 10TH ST S, LA CROSSE, WI 54601
(608) 782-4054
(608) 782-4054
Mailing address
615 10TH ST S, LA CROSSE, WI 54601
(608) 782-4054
(608) 782-2198
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5000873
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0945873
IOWA MEDICAL ASSISTANCE
IA
05
—
33563700
—
WI
Enumeration date
10/26/2005
Last updated
08/22/2020
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