Provider Demographics
NPI:1922404136
Name:BELL, PHILLIP (DMD)
Entity Type:Individual
Prefix:DR
First Name:PHILLIP
Middle Name:
Last Name:BELL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3034 RTE 35
Mailing Address - Street 2:
Mailing Address - City:HAZLET
Mailing Address - State:NJ
Mailing Address - Zip Code:07730-1505
Mailing Address - Country:US
Mailing Address - Phone:732-705-7565
Mailing Address - Fax:732-264-8009
Practice Address - Street 1:3034 RTE 35
Practice Address - Street 2:
Practice Address - City:HAZLET
Practice Address - State:NJ
Practice Address - Zip Code:07730-1505
Practice Address - Country:US
Practice Address - Phone:732-705-7565
Practice Address - Fax:732-264-8009
Is Sole Proprietor?:No
Enumeration Date:2014-11-16
Last Update Date:2014-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02588200122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist