Provider Demographics
NPI:1720130735
Name:BELLAMY, WILLIAM JAY (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:JAY
Last Name:BELLAMY
Suffix:
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 1:1324 E 1ST ST
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55805-2403
Mailing Address - Country:US
Mailing Address - Phone:218-724-1332
Mailing Address - Fax:218-724-2184
Practice Address - Street 1:1324 E 1ST ST
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55805-2403
Practice Address - Country:US
Practice Address - Phone:218-724-1332
Practice Address - Fax:218-724-2184
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND97891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice