Alexandra Ould Betlyon, D.M.D.
Individual provider Active NPI Dentist · Mill Hall, PA
NPI 1861602997 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1861602997
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- DS029410R (PA)
- Practice address
- 266 Hogan Blvd
Suite 6
Mill Hall, PA 17751-1928 - Phone
- (570) 748-5552
- NPI assigned
- May 24, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS029410R | PA | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DS029410R | PA | Yes |
Addresses
Primary practice location
266 Hogan Blvd
Suite 6
Mill Hall, PA 17751-1928
Mailing address
1243 Haymaker Rd
State College, PA 16801-6944
Phone (814) 861-8288
Other providers in Mill Hall, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.