Provider Demographics
NPI:1134828643
Name:BETANCOURT & PINNIX PLLC
Entity type:Organization
Organization Name:BETANCOURT & PINNIX PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:ALEXANDER
Authorized Official - Last Name:BETANCOURT
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:704-609-7143
Mailing Address - Street 1:801 MEDALLION DR
Mailing Address - Street 2:
Mailing Address - City:WAXHAW
Mailing Address - State:NC
Mailing Address - Zip Code:28173-9961
Mailing Address - Country:US
Mailing Address - Phone:704-609-7143
Mailing Address - Fax:
Practice Address - Street 1:15033 BALLANCROFT PKWY STE 102
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-4959
Practice Address - Country:US
Practice Address - Phone:704-771-1371
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-23
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental