Provider Demographics
NPI:1912227877
Name:BELL, JEFFREY GORDON (DDS)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:GORDON
Last Name:BELL
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 1:204 SAMPSON ST
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:NC
Mailing Address - Zip Code:28328-3418
Mailing Address - Country:US
Mailing Address - Phone:910-592-1883
Mailing Address - Fax:910-592-9181
Practice Address - Street 1:204 SAMPSON ST
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:NC
Practice Address - Zip Code:28328-3418
Practice Address - Country:US
Practice Address - Phone:910-592-1883
Practice Address - Fax:910-592-9181
Is Sole Proprietor?:No
Enumeration Date:2010-06-02
Last Update Date:2010-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9841122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist