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Individual

DR. STANLEY LEON BETTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
220 W COMMERCIAL ST, LYONS, KS 67554-2716
(620) 257-5193
(620) 257-5194
Mailing address
PO BOX 696, LYONS, KS 67554-0696
(620) 257-5193
(620) 257-5194

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4387
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1000959610A
KS
01
8289
BCBSKS
KS
Enumeration date
01/09/2013
Last updated
01/09/2013
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