Healthcare Provider Details

I. General information

NPI: 1477718690
Provider Name (Legal Business Name): KEITH M. BELL D.D.S
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2008
Last Update Date: 08/28/2025
Certification Date: 08/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 SOUTH RD
BROOKTONDALE NY
14817-9722
US

IV. Provider business mailing address

211 STILLWATER DR S
HORSEHEADS NY
14845-1329
US

V. Phone/Fax

Practice location:
  • Phone: 607-539-7121
  • Fax:
Mailing address:
  • Phone: 315-706-9467
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number045013
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: