MEDICARE: DR. MICHELLE DAVILA BELTON DDS

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	122300000X	Dentist	25817	TX

General Provider Information

NPI Number	:	1538476858
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHELLE DAVILA BELTON DDS

Provider Business Mailing Address
First Line	:	301 W ROCK ISLAND AVE
Second Line	:
City	:	BOYD
State	:	TX
Zip	:	76023-3105
Country	:	US
Telephone Number	:	214-771-7500
Fax Number	:	940-433-2233

Provider Business Practice Location Address
First Line	:	301 W. ROCK ISLAND AVENUE
Second Line	:
City	:	BOYD
State	:	TX
Zip	:	76023
Country	:	US
Telephone Number	:	615-579-1015
Fax Number	:

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

Provider Enumeration Date	:	09/08/2010
Last Update Date	:	11/06/2025

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