Provider Demographics
NPI:1780123190
Name:DAVID I. BELLER DDS LLC
Entity type:Organization
Organization Name:DAVID I. BELLER DDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:I
Authorized Official - Last Name:BELLER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:215-641-9020
Mailing Address - Street 1:809 N BETHLEHEM PIKE
Mailing Address - Street 2:PO BOX 29
Mailing Address - City:SPRING HOUSE
Mailing Address - State:PA
Mailing Address - Zip Code:19477
Mailing Address - Country:US
Mailing Address - Phone:215-641-9020
Mailing Address - Fax:215-540-9021
Practice Address - Street 1:809 N BETHLEHEM PIKE
Practice Address - Street 2:
Practice Address - City:SPRING HOUSE
Practice Address - State:PA
Practice Address - Zip Code:19477
Practice Address - Country:US
Practice Address - Phone:215-641-9020
Practice Address - Fax:215-540-9021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-17
Last Update Date:2017-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA026288122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty