Provider Demographics
NPI:1417395666
Name:BELL, LANDON DOUGLAS (DDS)
Entity Type:Individual
Prefix:
First Name:LANDON
Middle Name:DOUGLAS
Last Name:BELL
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 1:1204 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:TOOELE
Mailing Address - State:UT
Mailing Address - Zip Code:84074-9540
Mailing Address - Country:US
Mailing Address - Phone:435-579-4600
Mailing Address - Fax:435-578-0777
Practice Address - Street 1:612 W UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-1889
Practice Address - Country:US
Practice Address - Phone:940-484-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-10
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8687603-9922122300000X
TX30613122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist