DR. Scott Michael Bietsch, D.M.D.

NPI #1902119837 in Carbondale, Illinois

Provider Information

NPI Number: 1902119837
Entity Type: Individual
Name: DR. Scott Michael Bietsch, D.M.D.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Credential: D.M.D.
Enumeration Date: Jul 20, 2010
Last Updated: Dec 9, 2016

Practice Location

Address: 402 S LEWIS LN
City: Carbondale
State: Illinois
ZIP Code: 62901-3547
Phone: (618) 519-9200

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary
Dentist - Pediatric Dentistry — Pediatric Dentistry	1223P0221X

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