Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Dental |
261QD0000X |
| NPI # | 1457920548 |
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| LBN Legal business name | SABETHA DENTAL LLC | ||||
| Authorized official | ELIZABETH TEDMAN - (DENTIST-OWNER) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | No | ||||
| Enumeration date | 06/22/2021 | ||||
| Last updated | 07/31/2023 - About 3 years ago | ||||
| Identifiers |
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