Provider Demographics
NPI:1487701413
Name:MCQUEARY, BETSY B (DDS)
Entity type:Individual
Prefix:DR
First Name:BETSY
Middle Name:B
Last Name:MCQUEARY
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 1:3540 S NATIONAL AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65807-7309
Mailing Address - Country:US
Mailing Address - Phone:417-886-9094
Mailing Address - Fax:417-886-3604
Practice Address - Street 1:3540 S NATIONAL AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65807-7309
Practice Address - Country:US
Practice Address - Phone:417-886-9094
Practice Address - Fax:417-886-3604
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0145331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice