MEDICARE: DR. ANNA V BELOUS 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	049270-1	NY

General Provider Information

NPI Number	:	1790886836
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANNA V BELOUS DDS

Provider Business Mailing Address
First Line	:	23 WESTFIELD COMMONS
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14625-2916
Country	:	US
Telephone Number	:	585-671-9524
Fax Number	:

Provider Business Practice Location Address
First Line	:	2052 CLINTON AVE S
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14618-5703
Country	:	US
Telephone Number	:	585-244-3337
Fax Number	:	585-244-0622

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

Provider Enumeration Date	:	09/25/2006
Last Update Date	:	07/08/2007

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