Provider Demographics
NPI:1609921022
Name:BELL DENTAL CARE
Entity type:Organization
Organization Name:BELL DENTAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KOKOLIS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:7183-532-5582
Mailing Address - Street 1:214-35 42 AVE
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11361-2041
Mailing Address - Country:US
Mailing Address - Phone:718-352-5582
Mailing Address - Fax:718-352-5584
Practice Address - Street 1:214-35 42 AVE
Practice Address - Street 2:
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11361-2041
Practice Address - Country:US
Practice Address - Phone:718-352-5582
Practice Address - Fax:718-352-5584
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2015-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY04962411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty