Provider Demographics
NPI:1952315145
Name:RATLIFF, BETH ANN (DMD)
Entity Type:Individual
Prefix:DR
First Name:BETH
Middle Name:ANN
Last Name:RATLIFF
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 CARDINAL CT
Mailing Address - Street 2:
Mailing Address - City:SALYERSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41465-9114
Mailing Address - Country:US
Mailing Address - Phone:606-349-2812
Mailing Address - Fax:606-349-1739
Practice Address - Street 1:128 CARDINAL CT
Practice Address - Street 2:
Practice Address - City:SALYERSVILLE
Practice Address - State:KY
Practice Address - Zip Code:41465-9114
Practice Address - Country:US
Practice Address - Phone:606-349-2812
Practice Address - Fax:606-349-1739
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY81401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY60002805Medicaid