Provider Demographics
NPI:1972662203
Name:BELOTE, JAN O'KEEFE (DMD)
Entity Type:Individual
Prefix:DR
First Name:JAN
Middle Name:O'KEEFE
Last Name:BELOTE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:996 TOP ST
Mailing Address - Street 2:FAMILY DENTAL CARE
Mailing Address - City:FLOWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:39232-9541
Mailing Address - Country:US
Mailing Address - Phone:601-936-2526
Mailing Address - Fax:601-936-2426
Practice Address - Street 1:996 TOP ST
Practice Address - Street 2:FAMILY DENTAL CARE
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232-9541
Practice Address - Country:US
Practice Address - Phone:601-936-2526
Practice Address - Fax:601-936-2426
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2013-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS2531 901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice