Provider Demographics
NPI:1073738183
Name:BELLEGARRIGUE, ROBERTO (DMD)
Entity Type:Individual
Prefix:DR
First Name:ROBERTO
Middle Name:
Last Name:BELLEGARRIGUE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 S ARRAWANA AVE UNIT 1
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609-3258
Mailing Address - Country:US
Mailing Address - Phone:813-789-9091
Mailing Address - Fax:
Practice Address - Street 1:3331 W BEARSS AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-2100
Practice Address - Country:US
Practice Address - Phone:813-968-5368
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN15537122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist