Provider Demographics
NPI:1962668418
Name:BELTING, CHARLES WILLIAM (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:WILLIAM
Last Name:BELTING
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:CHARLES
Other - Middle Name:WILLIAM
Other - Last Name:BELTING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:203 S ROLLIE AVE
Mailing Address - Street 2:
Mailing Address - City:FORT LUPTON
Mailing Address - State:CO
Mailing Address - Zip Code:80621-1508
Mailing Address - Country:US
Mailing Address - Phone:303-286-4560
Mailing Address - Fax:303-286-4589
Practice Address - Street 1:729 E RAILROAD AVE
Practice Address - Street 2:
Practice Address - City:FORT MORGAN
Practice Address - State:CO
Practice Address - Zip Code:80701-3340
Practice Address - Country:US
Practice Address - Phone:970-867-0300
Practice Address - Fax:970-867-2511
Is Sole Proprietor?:No
Enumeration Date:2008-08-04
Last Update Date:2014-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO105969122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO02059699Medicaid