Provider Demographics
NPI:1831364199
Name:LEFEBVRE, BETSY ANN (DDS)
Entity type:Individual
Prefix:DR
First Name:BETSY
Middle Name:ANN
Last Name:LEFEBVRE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:BETSY
Other - Middle Name:ANN
Other - Last Name:TANKERSLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:360 MAMALA BAY DR
Mailing Address - Street 2:
Mailing Address - City:HICKAM AFB
Mailing Address - State:HI
Mailing Address - Zip Code:96853-5517
Mailing Address - Country:US
Mailing Address - Phone:808-448-7520
Mailing Address - Fax:808-448-7516
Practice Address - Street 1:360 MAMALA BAY DR
Practice Address - Street 2:BUILDING 3417
Practice Address - City:HICKAM AFB
Practice Address - State:HI
Practice Address - Zip Code:96853-5517
Practice Address - Country:US
Practice Address - Phone:808-448-7520
Practice Address - Fax:808-448-7516
Is Sole Proprietor?:No
Enumeration Date:2008-04-28
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA6104122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist