Individual
DR. ELIZABETH TEDMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
112 N 9TH ST, SABETHA, KS 66534-1806
(785) 284-2323
(785) 284-0075
Mailing address
112 N 9TH ST, SABETHA, KS 66534-1806
(785) 284-2323
(785) 284-0075
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6628
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
019255
BLUE CROSS BLUE SHIELD ID
KS
05
—
100226070-A
—
KS
05
—
1005342
—
KS
Enumeration date
09/15/2005
Last updated
02/12/2013
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