MEDICARE: DR. JEFFREY E BELLIN D.M.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	15348	MA

General Provider Information

NPI Number	:	1174687545
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY E BELLIN D.M.D

Provider Business Mailing Address
First Line	:	1212 RIVER ST
Second Line	:	PO BOX 366185
City	:	HYDE PARK
State	:	MA
Zip	:	02136-2906
Country	:	US
Telephone Number	:	617-361-4833
Fax Number	:

Provider Business Practice Location Address
First Line	:	1212 RIVER ST
Second Line	:
City	:	HYDE PARK
State	:	MA
Zip	:	02136-2906
Country	:	US
Telephone Number	:	617-361-4833
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/20/2006
Last Update Date	:	07/08/2007

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