Provider Demographics
NPI:1275674822
Name:BELZ, EDWARD K (DDS)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:K
Last Name:BELZ
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 1:6100 N DREXEL BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-4330
Mailing Address - Country:US
Mailing Address - Phone:405-848-0041
Mailing Address - Fax:405-848-0041
Practice Address - Street 1:6100 N DREXEL BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-4330
Practice Address - Country:US
Practice Address - Phone:405-848-0041
Practice Address - Fax:405-848-0041
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK47431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice