Provider Demographics
NPI:1164571808
Name:BELIVEAU, VICTOR JEROME (DMD)
Entity Type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:JEROME
Last Name:BELIVEAU
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 1:9535 N CITRUS SPRINGS BLVD
Mailing Address - Street 2:
Mailing Address - City:CITRUS SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34434
Mailing Address - Country:US
Mailing Address - Phone:352-465-3008
Mailing Address - Fax:352-465-3009
Practice Address - Street 1:9535 N CITRUS SPRINGS BLVD
Practice Address - Street 2:
Practice Address - City:CITRUS SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34434
Practice Address - Country:US
Practice Address - Phone:352-465-3008
Practice Address - Fax:352-465-3009
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN14034122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist