Provider Demographics
NPI:1962589721
Name:BELL, JEFFREY ALAN (DDS)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:ALAN
Last Name:BELL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2400 S KENSINGTON DRIVE
Mailing Address - Street 2:SUITE 500
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54915-4187
Mailing Address - Country:US
Mailing Address - Phone:920-882-1473
Mailing Address - Fax:920-882-1494
Practice Address - Street 1:2400 SOUTH KENSINGTON DRIVE
Practice Address - Street 2:500
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54915-4187
Practice Address - Country:US
Practice Address - Phone:920-882-1473
Practice Address - Fax:920-882-1494
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5249015122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist