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General NPI Number Information
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NPI Number | 1407397581
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Entity Type | Organization
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Legal Business Name | MATTHEW BELLAFIORE DDS PC
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Dates
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Enumeration Date | 03/09/2017
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Last Update Date | 03/09/2017
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Provider Practice Location Address
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Address Line | 185 MONTAGUE ST # F3
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City | BROOKLYN
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State | NY
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Zip | 01121-3608
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Country | US
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Telephone | 718-875-9424
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Fax | 718-875-2630
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Provider Business Mailing Address
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Address Line | 185 MONTAGUE ST FL 3
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City | BROOKLYN
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State | NY
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Zip | 11201-3608
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Country | US
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Telephone | 718-875-9424
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Fax | 718-875-2630
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Authorized Official
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Title or Position | OWNER
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Name | DR. MATTHEW L BELLAFIORE
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Credential | DDS
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Telephone | 718-875-9424
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 043328
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License Number State | NY
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