Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 0401008358 | VA |
NPI | 1013038132 |
---|---|
Provider Name | Dr. Stephen A Belmonte |
First Address | Leesburg, VA 20176 |
Second Address | Leesburg, VA 20176 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2007 |
Last Update Date | 08/07/2007 |