Provider Demographics
NPI:1629274261
Name:BELSITO, JOSEPH ANTONIO (DDS FAGD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:ANTONIO
Last Name:BELSITO
Suffix:
Gender:M
Credentials:DDS FAGD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2095 WYANDOTTE ST W
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:ONT
Mailing Address - Zip Code:N9B1J8
Mailing Address - Country:CA
Mailing Address - Phone:519-258-1240
Mailing Address - Fax:519-258-3107
Practice Address - Street 1:2095 WYANDOTTE ST W
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:ONT
Practice Address - Zip Code:N9B1J8
Practice Address - Country:CA
Practice Address - Phone:519-258-1240
Practice Address - Fax:519-258-3107
Is Sole Proprietor?:No
Enumeration Date:2007-06-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI0610947122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist