Provider Demographics
NPI:1013328442
Name:VICTORIA C. BETTIS, DDS,LLC
Entity Type:Organization
Organization Name:VICTORIA C. BETTIS, DDS,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:C
Authorized Official - Last Name:BETTIS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:276-669-1370
Mailing Address - Street 1:14391 LEE HWY
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:VA
Mailing Address - Zip Code:24202-4319
Mailing Address - Country:US
Mailing Address - Phone:276-669-1370
Mailing Address - Fax:276-669-6348
Practice Address - Street 1:14391 LEE HWY
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:VA
Practice Address - Zip Code:24202-4319
Practice Address - Country:US
Practice Address - Phone:276-669-1370
Practice Address - Fax:276-669-6348
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-20
Last Update Date:2014-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty