Individual
JOHN H. BETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
615 10TH ST S, LA CROSSE, WI 54601-4768
(608) 782-4054
(608) 782-2198
Mailing address
615 10TH ST S, LA CROSSE, WI 54601-4768
(608) 782-4054
(608) 782-2198
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
5000873
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0945873
—
IA
05
—
33563700
—
WI
01
—
820798
UNITED CONCORDIA
—
Enumeration date
10/12/2006
Last updated
07/09/2007
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