Healthcare Provider Details

I. General information

NPI: 1740464502
Provider Name (Legal Business Name): G STEPHEN BELL DDS MS PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2007
Last Update Date: 12/28/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

805 W WARREN ST
SHELBY NC
28150
US

IV. Provider business mailing address

PO BOX 548 805 W WARREN ST
SHELBY NC
28150
US

V. Phone/Fax

Practice location:
  • Phone: 704-484-1633
  • Fax: 704-484-1632
Mailing address:
  • Phone: 704-484-1633
  • Fax: 704-484-1632

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number4168
License Number StateNC

VIII. Authorized Official

Name: DR. GARY STEPHEN BELL
Title or Position: PRESIDENT
Credential: DDS MS
Phone: 704-484-1633