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General NPI Number Information
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NPI Number | 1063728285
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Entity Type | Individual
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Provider Name | JEREMY F BELL D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 08/25/2010
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Last Update Date | 08/25/2010
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Provider Practice Location Address
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Address Line | 2260 NORTH AVE
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City | BRIDGEPORT
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State | CT
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Zip | 06604-2413
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Country | US
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Telephone | 203-853-2732
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Fax |
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Provider Business Mailing Address
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Address Line | 226 2ND AVE 2ND FLOOR
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City | MILFORD
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State | CT
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Zip | 06460-5235
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Country | US
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Telephone | 801-830-3011
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 010349
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License Number State | CT
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