Healthcare Provider Details

I. General information

NPI: 1871541698
Provider Name (Legal Business Name): PATRICK STANLEY BELL DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 07/18/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 DEL WEBB BLVD STE 104
GEORGETOWN TX
78633-4354
US

IV. Provider business mailing address

400 DEL WEBB BLVD STE 104
GEORGETOWN TX
78633-4354
US

V. Phone/Fax

Practice location:
  • Phone: 512-868-5000
  • Fax:
Mailing address:
  • Phone: 512-868-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number23130
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: