Healthcare Provider Details

I. General information

NPI: 1750006896
Provider Name (Legal Business Name): BELL ORTHODONTICS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2022
Last Update Date: 10/11/2022
Certification Date: 10/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 19TH ST S STE 101
SARTELL MN
56377-2570
US

IV. Provider business mailing address

325 19TH ST S STE 101
SARTELL MN
56377-2570
US

V. Phone/Fax

Practice location:
  • Phone: 320-251-7109
  • Fax:
Mailing address:
  • Phone: 320-251-7109
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ERIC BELL
Title or Position: OWNER
Credential: DDS
Phone: 320-251-7109