Provider Demographics
NPI:1194744961
Name:BELLER, CHRISTOPHER JAY (DDS)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:JAY
Last Name:BELLER
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 1:635 E BOSWELL ST
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72501-4608
Mailing Address - Country:US
Mailing Address - Phone:870-698-1837
Mailing Address - Fax:870-698-2977
Practice Address - Street 1:635 E BOSWELL ST
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:AR
Practice Address - Zip Code:72501-4608
Practice Address - Country:US
Practice Address - Phone:870-698-1837
Practice Address - Fax:870-698-2977
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2021-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR34391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice