Provider Demographics
NPI:1134211402
Name:BELL, NATHAN DEVAUGHN JR (DDS)
Entity type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:DEVAUGHN
Last Name:BELL
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12209 AMORETTO WAY
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27613-5623
Mailing Address - Country:US
Mailing Address - Phone:919-846-3957
Mailing Address - Fax:
Practice Address - Street 1:801 JONES FRANKLIN RD
Practice Address - Street 2:SUITE 150
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27606-3381
Practice Address - Country:US
Practice Address - Phone:919-852-0403
Practice Address - Fax:919-852-0562
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6120122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist