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General NPI Number Information
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NPI Number | 1720174832
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Entity Type | Individual
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Provider Name | MICHAEL JOHN BELTON DDS, MD INC
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Gender | Male
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Dates
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Enumeration Date | 10/05/2006
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Last Update Date | 06/28/2016
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Provider Practice Location Address
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Address Line | 10470 FOOTHILL BLVD SUITE 122
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-3754
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Country | US
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Telephone | 909-989-2303
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Fax |
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Provider Business Mailing Address
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Address Line | 9471 JACK RABBIT DR UNIT 103
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-2776
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Country | US
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Telephone | 909-483-6864
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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 | 52203
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 204E00000X
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Taxonomy Name | Oral & Maxillofacial Surgery (D.M.D.)
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License Number | A90801
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License Number State | CA
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