Betlej, Anna M
Betlej, Anna M is an individual health care provider with primary practice located at 5328 Coldwater Rd , Fort Wayne IN 46825-5445. She recently has only one registered license in Dental Providers / Orthodontics and Dentofacial Orthopedics, which is considered as her primary health care specialty. Betlej, Anna M can be contacted via phone (260) 471-5016.Contact Information
Primary practice address
5328 Coldwater Rd
Fort Wayne IN 46825-5445
Phone: (260) 471-5016
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Orthodontics and Dentofacial Orthopedics | 1223X0400X | 12013698A | Indiana |
Profile Details
| NPI number | 1104592724 |
|---|---|
| LBN Legal business name | Betlej, Anna M |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 23rd, 2021 |
| Last updated | Sep 15th, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104592724 | NPPES |
| Indiana | Other | 12013698A | STATE DENTAL BOARD |
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