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Individual

BENJAMIN NEAL BELLAVANCE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
23RD DENTAL COMPANY 1591 GRIFFIN ROAD, TWENTYNINE PALMS, CA 92278
(760) 830-7054
Mailing address
35 SCHOOL ST, REHOBOTH, MA 02769-2203
(774) 565-0214

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
14231492-9926
UT
261QS1000X
Student Health Clinic/Center

Other

Enumeration date
01/29/2024
Last updated
07/22/2025
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