Provider Demographics
NPI:1548248156
Name:BELL, LEROY (DDM)
Entity type:Individual
Prefix:DR
First Name:LEROY
Middle Name:
Last Name:BELL
Suffix:
Gender:M
Credentials:DDM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 OSPREY CT
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:DE
Mailing Address - Zip Code:19934-2012
Mailing Address - Country:US
Mailing Address - Phone:302-697-3994
Mailing Address - Fax:
Practice Address - Street 1:102 OSPREY CT
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:DE
Practice Address - Zip Code:19934-2012
Practice Address - Country:US
Practice Address - Phone:302-697-3994
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2014-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN008599122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist