Provider Demographics
NPI:1861624686
Name:BACHMAN, BETH ALISON (DDS)
Entity type:Individual
Prefix:DR
First Name:BETH
Middle Name:ALISON
Last Name:BACHMAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:494 S EMERSON AVE STE K
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-1953
Mailing Address - Country:US
Mailing Address - Phone:317-882-2880
Mailing Address - Fax:317-882-2544
Practice Address - Street 1:494 S EMERSON AVE STE K
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-1953
Practice Address - Country:US
Practice Address - Phone:317-882-2880
Practice Address - Fax:317-882-2544
Is Sole Proprietor?:No
Enumeration Date:2009-08-12
Last Update Date:2014-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12011308A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist