Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 18196 | OH |
NPI | 1003036567 |
---|---|
Provider Name | Stephen J. Belli |
First Address | Kent, OH 44240-4441 |
Second Address | Kent, OH 44240-4441 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2007 |
Last Update Date | 08/07/2007 |