Healthcare Provider Details

I. General information

NPI: 1962566828
Provider Name (Legal Business Name): JEFFREY GEORGE BELL D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

312 E MAIN ST
MIDDLEBURG PA
17842-1106
US

IV. Provider business mailing address

312 E MAIN ST
MIDDLEBURG PA
17842-1106
US

V. Phone/Fax

Practice location:
  • Phone: 570-837-5117
  • Fax:
Mailing address:
  • Phone: 570-837-5117
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDS-024186L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: