Provider Demographics
NPI:1225331838
Name:GAIL M D BELVETT DDS AND ASSOCIATES PA
Entity Type:Organization
Organization Name:GAIL M D BELVETT DDS AND ASSOCIATES PA
Other - Org Name:MEBANE CHILDREN'S DENTRISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:MEREDITH DAWN
Authorized Official - Last Name:BELVETT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:919-682-9707
Mailing Address - Street 1:1208 RIDDLE RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-1294
Mailing Address - Country:US
Mailing Address - Phone:919-682-9707
Mailing Address - Fax:919-682-0306
Practice Address - Street 1:1107 S FIFTH ST
Practice Address - Street 2:SUITE 100
Practice Address - City:MEBANE
Practice Address - State:NC
Practice Address - Zip Code:27302-9597
Practice Address - Country:US
Practice Address - Phone:919-682-9707
Practice Address - Fax:919-682-0306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-21
Last Update Date:2010-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC72501223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty