| Betty Tucker, D.d.s., Llc | |
|
6438 Wilmington Pike Ste 205 Centerville OH 45459-7023 | |
| (937) 848-1116 | |
| Not Available |
| Full Name | Betty Tucker, D.d.s., Llc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 6438 Wilmington Pike Ste 205, Centerville, Ohio |
| Authorized Official Name and Position | Betty Huang Tucker (PRESIDENT) |
| Authorized Official Contact | 4194630023 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Betty Tucker, D.d.s., Llc 8607 Sea Pines Ln Dayton OH 45458-3321 Ph: (419) 463-0023 | Betty Tucker, D.d.s., Llc 6438 Wilmington Pike Ste 205 Centerville OH 45459-7023 Ph: (937) 848-1116 |
| NPI Number | 1548788631 |
|---|---|
| Provider Enumeration Date | 09/08/2017 |
| Last Update Date | 09/08/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548788631 | NPI | - | NPPES |
| 0054438 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 30.023424 (Ohio) | Primary |
Professional Dental Alliance Of Centerville, Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 9420 Dayton Lebanon Pike, Centerville, OH 45458 Phone: 937-433-8900 | |