Provider Demographics
NPI:1760691216
Name:BELMAN, LEO (DDS)
Entity Type:Individual
Prefix:DR
First Name:LEO
Middle Name:
Last Name:BELMAN
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 1:100 BETH DRIVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19115-2703
Mailing Address - Country:US
Mailing Address - Phone:215-671-9833
Mailing Address - Fax:215-671-7784
Practice Address - Street 1:100 BETH DRIVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19115-2703
Practice Address - Country:US
Practice Address - Phone:215-671-9833
Practice Address - Fax:215-671-7784
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS017352L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
179315OtherUNITED CONCORDIA