Provider Demographics
NPI:1740807361
Name:WILLIAM BELL, DMD, MD, P.A.
Entity Type:Organization
Organization Name:WILLIAM BELL, DMD, MD, P.A.
Other - Org Name:WILLIAM BELL, DMD, MD, P.A.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:H
Authorized Official - Last Name:BELL
Authorized Official - Suffix:IV
Authorized Official - Credentials:DMD, MD
Authorized Official - Phone:321-777-2166
Mailing Address - Street 1:2030 S PATRICK DRIVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:INDIAN HARBOUR BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32937-4400
Mailing Address - Country:US
Mailing Address - Phone:321-777-2166
Mailing Address - Fax:321-777-2191
Practice Address - Street 1:2030 SOUTH PATRICK DRIVE
Practice Address - Street 2:SUITE 1
Practice Address - City:INDIAN HARBOUR BEACH
Practice Address - State:FL
Practice Address - Zip Code:32937
Practice Address - Country:US
Practice Address - Phone:321-777-2166
Practice Address - Fax:321-777-2191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-30
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1306832431OtherASSOCIATE (DR. TIMOTHY LANG)