NPI 1740413012

Anthony Ray Belisle, LD

Practitioner Denturist Coos Bay, OR

Practice location

Address: 965 S 1st St, Coos Bay, OR 97420-1401
Phone: (541) 267-7278
Fax: (541) 269-4613
Mailing address: PO Box 3520, Coos Bay, OR 97420-0418

Registered specialties (2)

Denturist Primary

Dental Providers Taxonomy 122400000X Licence DT-DO-1003340 (OR)

Other Denturist providers in Oregon →

Dental Laboratory Technician

Dental Providers Taxonomy 126900000X

Other Dental Laboratory Technician providers in Oregon →

Registry record

NPI: 1740413012
Entity type: Individual
Sex (as registered): Male
NPI issued: 2 Sep 2009
Record last updated: 2 Sep 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.