Individual
DR. TRAVIS BELLICCHI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD, MS
Contact information
Practice address
101 BODIN CIR, TRAVIS AFB, CA 94535-1809
(707) 423-7052
Mailing address
101 BODIN CIR, TRAVIS AFB, CA 94535-1809
(707) 423-7052
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
12012188A
IN
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
06/18/2014
Last updated
05/18/2023
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