Individual
MOLLY BEUTEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
30-021926
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2550476
—
OH
01
—
341609341036
CARESOURCE
OH
Enumeration date
08/29/2006
Last updated
11/07/2017
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