Provider Demographics
NPI:1669656138
Name:BELLER, DAVID ISRAEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ISRAEL
Last Name:BELLER
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:PO BOX 29
Mailing Address - Street 2:
Mailing Address - City:SPRING HOUSE
Mailing Address - State:PA
Mailing Address - Zip Code:19477-0029
Mailing Address - Country:US
Mailing Address - Phone:215-641-9020
Mailing Address - Fax:215-540-9021
Practice Address - Street 1:809 N BETHLEHEM PIKE
Practice Address - Street 2:
Practice Address - City:SPRINGHOUSE
Practice Address - State:PA
Practice Address - Zip Code:19477
Practice Address - Country:US
Practice Address - Phone:215-641-9020
Practice Address - Fax:215-540-9021
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-20
Last Update Date:2007-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS026288L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PADS026288LOtherDENTAL LICENSE