Provider Demographics
NPI:1215152129
Name:BELVIDERE DENTAL ASSOCIATES, P.C.
Entity type:Organization
Organization Name:BELVIDERE DENTAL ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:BELBY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:908-475-3641
Mailing Address - Street 1:984 BRASS CASTLE RD
Mailing Address - Street 2:
Mailing Address - City:BELVIDERE
Mailing Address - State:NJ
Mailing Address - Zip Code:07823-2752
Mailing Address - Country:US
Mailing Address - Phone:908-475-3641
Mailing Address - Fax:
Practice Address - Street 1:984 BRASS CASTLE RD
Practice Address - Street 2:
Practice Address - City:BELVIDERE
Practice Address - State:NJ
Practice Address - Zip Code:07823-2752
Practice Address - Country:US
Practice Address - Phone:908-475-3641
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI0138861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty