Individual
BETHANY JOY MACINTOSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
4625 VIRGINIA BEACH BLVD STE 101A, VIRGINIA BEACH, VA 23462-7789
(757) 675-8460
Mailing address
6357 SHOWY CT, WESTERVILLE, OH 43081-3727
(850) 266-5988
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401416447
VA
Other
Enumeration date
04/05/2019
Last updated
04/05/2019
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