Provider Demographics
NPI:1518405430
Name:DENTAL BETEL CORPORATION
Entity Type:Organization
Organization Name:DENTAL BETEL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GRISEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DEL CUETO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-774-9709
Mailing Address - Street 1:18700 SHERMAN WAY
Mailing Address - Street 2:201
Mailing Address - City:RESEDA
Mailing Address - State:CA
Mailing Address - Zip Code:91335-4041
Mailing Address - Country:US
Mailing Address - Phone:818-643-4940
Mailing Address - Fax:
Practice Address - Street 1:18700 SHERMAN WAY
Practice Address - Street 2:201
Practice Address - City:RESEDA
Practice Address - State:CA
Practice Address - Zip Code:91335-4041
Practice Address - Country:US
Practice Address - Phone:818-643-4940
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-11
Last Update Date:2017-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA505911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty