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General NPI Number Information
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NPI Number | 1689775926
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Entity Type | Individual
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Provider Name | ROBERT P. BELLOHUSEN D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/26/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 217 STEUBEN ST
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City | HORSEHEADS
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State | NY
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Zip | 14845-2420
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Country | US
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Telephone | 607-739-2324
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Fax |
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Provider Business Mailing Address
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Address Line | 205 OAK HILL RD
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City | HORSEHEADS
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State | NY
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Zip | 14845-8128
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Country | US
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Telephone | 607-796-9227
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 034416
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License Number State | NY
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