Provider Demographics
NPI:1962796730
Name:VERONICA BELLO DDS MSD PLLC
Entity type:Organization
Organization Name:VERONICA BELLO DDS MSD PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:C
Authorized Official - Last Name:BELLO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS MSD
Authorized Official - Phone:206-427-6164
Mailing Address - Street 1:11050 5TH AVE NE STE 202
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-6151
Mailing Address - Country:US
Mailing Address - Phone:206-427-6164
Mailing Address - Fax:
Practice Address - Street 1:11050 5TH AVE NE STE 202
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125-6151
Practice Address - Country:US
Practice Address - Phone:206-427-6164
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-08
Last Update Date:2011-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE600185751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty