Provider Demographics
NPI:1598895997
Name:BELONGIA, DENISE LYNN (RDH)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:LYNN
Last Name:BELONGIA
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 SHERIDAN ST APT 15
Mailing Address - Street 2:
Mailing Address - City:OCONTO FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54154-1645
Mailing Address - Country:US
Mailing Address - Phone:920-373-7017
Mailing Address - Fax:
Practice Address - Street 1:1210 PECOR ST
Practice Address - Street 2:
Practice Address - City:OCONTO
Practice Address - State:WI
Practice Address - Zip Code:54153-1768
Practice Address - Country:US
Practice Address - Phone:920-834-5737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3650-016124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist