Individual
LARRE L BETSWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2301 SW 6TH AVE, TOPEKA, KS 66606-1759
(785) 233-1162
(785) 233-4169
Mailing address
2301 SW 6TH AVE, TOPEKA, KS 66606-1759
(785) 233-1162
(785) 233-4169
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6550
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22957
BLUECROSS BLUE SHIELD
KS
01
—
785405
UNITED CONCORDIA-TRICARE
—
Enumeration date
06/15/2005
Last updated
11/15/2010
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