Individual
DR. DONALD ALAN BETHEA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
410 LISTER ST, WAYCROSS, GA 31501-5226
(912) 285-1218
(912) 285-9518
Mailing address
410 LISTER ST, WAYCROSS, GA 31501-5226
(912) 285-1218
(912) 285-9518
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DN011225
GA
1223P0221X
Pediatric Dentistry
DS6972
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003143408A
—
GA
Enumeration date
09/15/2006
Last updated
06/18/2014
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