Provider Demographics
NPI:1386474930
Name:BELL, BROOKE C (DMD)
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:C
Last Name:BELL
Suffix:
Gender:F
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 297
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MS
Mailing Address - Zip Code:39095-0297
Mailing Address - Country:US
Mailing Address - Phone:662-834-1585
Mailing Address - Fax:662-834-1583
Practice Address - Street 1:PO BOX 297
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MS
Practice Address - Zip Code:39095-0297
Practice Address - Country:US
Practice Address - Phone:662-834-1585
Practice Address - Fax:662-834-1583
Is Sole Proprietor?:No
Enumeration Date:2024-08-07
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS4476-24122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist