Provider Demographics
NPI:1477718690
Name:BELL, KEITH M (DDS)
Entity Type:Individual
Prefix:DR
First Name:KEITH
Middle Name:M
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 1:201 WARD ST
Mailing Address - Street 2:SUITE H
Mailing Address - City:MONTGOMERY
Mailing Address - State:NY
Mailing Address - Zip Code:12549-1248
Mailing Address - Country:US
Mailing Address - Phone:845-457-4373
Mailing Address - Fax:845-457-4264
Practice Address - Street 1:201 WARD ST
Practice Address - Street 2:SUITE H
Practice Address - City:MONTGOMERY
Practice Address - State:NY
Practice Address - Zip Code:12549-1248
Practice Address - Country:US
Practice Address - Phone:845-457-4373
Practice Address - Fax:845-457-4264
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-28
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0450131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice