MEDICARE: DR. LOUIS FRANK BELLOTTI DMD

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	1223P0700X	Prosthodontics	11292	NJ

General Provider Information

NPI Number	:	1558428995
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LOUIS FRANK BELLOTTI DMD

Provider Business Mailing Address
First Line	:	1118 BRIAR WAY
Second Line	:
City	:	FORT LEE
State	:	NJ
Zip	:	07024-6343
Country	:	US
Telephone Number	:	201-886-9336
Fax Number	:	201-886-3821

Provider Business Practice Location Address
First Line	:	481 EDSALL BLVD
Second Line	:
City	:	FORT LEE
State	:	NJ
Zip	:	07024-1942
Country	:	US
Telephone Number	:	201-224-5600
Fax Number	:	201-224-2613

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

Provider Enumeration Date	:	01/03/2007
Last Update Date	:	07/08/2007

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