Provider Demographics
NPI:1063728285
Name:BELL, JEREMY F (DDS)
Entity type:Individual
Prefix:DR
First Name:JEREMY
Middle Name:F
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 1:226 2ND AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-5235
Mailing Address - Country:US
Mailing Address - Phone:801-830-3011
Mailing Address - Fax:
Practice Address - Street 1:2260 NORTH AVE
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06604-2413
Practice Address - Country:US
Practice Address - Phone:203-853-2732
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-25
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT010349122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist