Healthcare Provider Details

I. General information

NPI: 1740807361
Provider Name (Legal Business Name): WILLIAM BELL, DMD, MD, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2020
Last Update Date: 07/20/2020
Certification Date: 07/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2030 SOUTH PATRICK DRIVE SUITE 1
INDIAN HARBOUR BEACH FL
32937
US

IV. Provider business mailing address

2030 S PATRICK DRIVE SUITE 1
INDIAN HARBOUR BEACH FL
32937-4400
US

V. Phone/Fax

Practice location:
  • Phone: 321-777-2166
  • Fax: 321-777-2191
Mailing address:
  • Phone: 321-777-2166
  • Fax: 321-777-2191

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State

VIII. Authorized Official

Name: DR. WILLIAM H BELL IV
Title or Position: OWNER
Credential: DMD, MD
Phone: 321-777-2166