Provider Demographics
NPI:1912201948
Name:BELLA SHEN GARNETT, DMD, MMSC PC
Entity Type:Organization
Organization Name:BELLA SHEN GARNETT, DMD, MMSC PC
Other - Org Name:BELLA SMILE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BELLA
Authorized Official - Middle Name:S
Authorized Official - Last Name:GARNETT
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, MMSC
Authorized Official - Phone:415-292-2345
Mailing Address - Street 1:390 LAUREL ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118-1980
Mailing Address - Country:US
Mailing Address - Phone:415-292-2345
Mailing Address - Fax:415-292-0660
Practice Address - Street 1:390 LAUREL ST
Practice Address - Street 2:SUITE 100
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-1980
Practice Address - Country:US
Practice Address - Phone:415-292-2345
Practice Address - Fax:415-292-0660
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-05
Last Update Date:2011-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA489961223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty