Healthcare Provider Details

I. General information

NPI: 1558410944
Provider Name (Legal Business Name): MICHAEL D BELLON DDS MS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7200 E HAMPDEN AVE #203
DENVER CO
80224-3021
US

IV. Provider business mailing address

7200 E HAMPDEN AVE #203
DENVER CO
80224-3021
US

V. Phone/Fax

Practice location:
  • Phone: 303-692-9610
  • Fax: 303-692-9680
Mailing address:
  • Phone: 303-692-9610
  • Fax: 303-692-9680

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number6623
License Number StateCO

VIII. Authorized Official

Name: DR. MICHAEL DREW BELLON
Title or Position: ORTHODONTIST
Credential: DDS MS
Phone: 303-692-9610