Provider Demographics
NPI:1023187549
Name:BELDEN, TERRY D (DDS)
Entity Type:Individual
Prefix:DR
First Name:TERRY
Middle Name:D
Last Name:BELDEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4901 NORTH 44TH STREET
Mailing Address - Street 2:#100
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-8393
Mailing Address - Country:US
Mailing Address - Phone:602-840-1217
Mailing Address - Fax:602-840-6866
Practice Address - Street 1:4901 NORTH 44TH STREET
Practice Address - Street 2:#100
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-8393
Practice Address - Country:US
Practice Address - Phone:602-840-1217
Practice Address - Fax:602-840-6866
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2011-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ50551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice