Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. ANTHONY RAY BELISLE JR., L.D.
Active Sole Proprietor122400000X · COOS BAY, OR
Registration Details
- NPI Number
- 1740413012
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Sep 2, 2009 (16.654153865614 yrs)
- Last Updated
- Sep 2, 2009
- License
-
DT-DO-1003340 (OR)
- Sole Proprietor
- Yes
Practice Information
- Address
-
965 S 1ST STCOOS BAY, OR, 974201401Browse OR providers · Browse ZIP 97420
- Phone
- 5412677278
- Fax
- 5412694613
- Primary Specialty
-
122400000X
122400000X
- Additional Specialty
- Dental Laboratory Technician
Other 122400000X Providers in COOS BAY, OR
| Name | Credential | NPI |
|---|---|---|
| AUSTIN MITCHELL NEWSOME | LD | 1093372039 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.