Provider Demographics
NPI:1538100045
Name:BELLER DENTAL CLINIC PLLC
Entity Type:Organization
Organization Name:BELLER DENTAL CLINIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:BELLER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:870-698-1837
Mailing Address - Street 1:635 E BOSWELL ST
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72501-4608
Mailing Address - Country:US
Mailing Address - Phone:870-698-2977
Mailing Address - Fax:
Practice Address - Street 1:635 E BOSWELL ST
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:AR
Practice Address - Zip Code:72501-4608
Practice Address - Country:US
Practice Address - Phone:870-698-2977
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-08
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR18321223G0001X
AR34391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty