Provider Demographics
NPI:1689774853
Name:BELSHEIM, HOWARD GEORGE (DDS)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:GEORGE
Last Name:BELSHEIM
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 1:216 SOUTH NILE KINNICK DRIVE
Mailing Address - Street 2:
Mailing Address - City:ADEL
Mailing Address - State:IA
Mailing Address - Zip Code:50003-1727
Mailing Address - Country:US
Mailing Address - Phone:515-993-4333
Mailing Address - Fax:515-993-6770
Practice Address - Street 1:216 SOUTH NILE KINNICK DRIVE
Practice Address - Street 2:
Practice Address - City:ADEL
Practice Address - State:IA
Practice Address - Zip Code:50003-1727
Practice Address - Country:US
Practice Address - Phone:515-993-4333
Practice Address - Fax:515-993-6770
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA7600122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA2105387Medicaid