Provider Demographics
NPI:1790032969
Name:BELL, BRANDON ROBERT (DDS)
Entity Type:Individual
Prefix:
First Name:BRANDON
Middle Name:ROBERT
Last Name:BELL
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 1:804 CARLSBAD VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-2318
Mailing Address - Country:US
Mailing Address - Phone:760-729-8500
Mailing Address - Fax:760-729-6097
Practice Address - Street 1:804 CARLSBAD VILLAGE DR
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-2318
Practice Address - Country:US
Practice Address - Phone:760-729-8500
Practice Address - Fax:760-729-6097
Is Sole Proprietor?:No
Enumeration Date:2012-08-07
Last Update Date:2012-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA61694122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist