Provider Demographics
NPI:1003939570
Name:DAVID J BELLEW DDS PC
Entity type:Organization
Organization Name:DAVID J BELLEW DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:J
Authorized Official - Last Name:BELLEW
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:318-797-4550
Mailing Address - Street 1:1945 E 70TH ST
Mailing Address - Street 2:STE D
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71105
Mailing Address - Country:US
Mailing Address - Phone:318-797-4550
Mailing Address - Fax:318-797-4565
Practice Address - Street 1:1945 E 70TH ST
Practice Address - Street 2:STE D
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71105
Practice Address - Country:US
Practice Address - Phone:318-797-4550
Practice Address - Fax:318-797-4565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA37571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty