Provider Demographics
NPI:1942409925
Name:BELSKY, BRUCE E (DMD)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:E
Last Name:BELSKY
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 1:7855 FAY AVE
Mailing Address - Street 2:SUITE 260
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-4265
Mailing Address - Country:US
Mailing Address - Phone:858-551-2400
Mailing Address - Fax:858-551-1072
Practice Address - Street 1:7855 FAY AVE
Practice Address - Street 2:SUITE 260
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-4265
Practice Address - Country:US
Practice Address - Phone:858-551-2400
Practice Address - Fax:858-551-1072
Is Sole Proprietor?:No
Enumeration Date:2007-07-11
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD405371223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics