Healthcare Provider Details

I. General information

NPI: 1922404136
Provider Name (Legal Business Name): PHILLIP BELL D.M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/16/2014
Last Update Date: 11/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3034 RTE 35
HAZLET NJ
07730-1505
US

IV. Provider business mailing address

3034 RTE 35
HAZLET NJ
07730-1505
US

V. Phone/Fax

Practice location:
  • Phone: 732-705-7565
  • Fax: 732-264-8009
Mailing address:
  • Phone: 732-705-7565
  • Fax: 732-264-8009

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number22DI02588200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: