Provider Demographics
NPI:1306925656
Name:BELLAMY, MARCUS (DMD)
Entity type:Individual
Prefix:DR
First Name:MARCUS
Middle Name:
Last Name:BELLAMY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1649
Mailing Address - Street 2:
Mailing Address - City:MONUMENT
Mailing Address - State:CO
Mailing Address - Zip Code:80132-1649
Mailing Address - Country:US
Mailing Address - Phone:719-488-2721
Mailing Address - Fax:
Practice Address - Street 1:236 WASHINGTON ST
Practice Address - Street 2:STE 1W
Practice Address - City:MONUMENT
Practice Address - State:CO
Practice Address - Zip Code:80132-1649
Practice Address - Country:US
Practice Address - Phone:719-488-2721
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO8467122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist