Provider Demographics
NPI:1447264072
Name:BELL, GORDON M (DDS)
Entity type:Individual
Prefix:
First Name:GORDON
Middle Name:M
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 1:450 W MARKET ST
Mailing Address - Street 2:
Mailing Address - City:HELLAM
Mailing Address - State:PA
Mailing Address - Zip Code:17406-1024
Mailing Address - Country:US
Mailing Address - Phone:717-757-4878
Mailing Address - Fax:717-840-4710
Practice Address - Street 1:450 W MARKET ST
Practice Address - Street 2:
Practice Address - City:HELLAM
Practice Address - State:PA
Practice Address - Zip Code:17406-1024
Practice Address - Country:US
Practice Address - Phone:717-757-4878
Practice Address - Fax:717-840-4710
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS026963L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice