MEDICARE: DR. GREGORY BELOK DDS,MPH

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	22DI01063500	NJ

General Provider Information

NPI Number	:	1962492157
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GREGORY BELOK DDS,MPH

Provider Business Mailing Address
First Line	:	2460 LEMOINE AVE
Second Line	:	4TH FLOOR
City	:	FORT LEE
State	:	NJ
Zip	:	07024-6231
Country	:	US
Telephone Number	:	201-461-0618
Fax Number	:

Provider Business Practice Location Address
First Line	:	MITSUWA MARKETPLACE 595 RIVER RD
Second Line	:
City	:	EDGEWATER
State	:	NJ
Zip	:	07020-1104
Country	:	US
Telephone Number	:	201-945-3202
Fax Number	:

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

Provider Enumeration Date	:	10/27/2005
Last Update Date	:	07/08/2007

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