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Mr. Anthony Ray Belisle JR., LD
Dental Laboratory Technician in Coos Bay, Oregon
NPI 1740413012

Anthony Ray Belisle JR. is a Dental Laboratory Technician based in Coos Bay, OR. Anthony Ray Belisle JR. practices in Coos Bay, OR and has the professional credentials of LD. The NPI Number for Anthony Ray Belisle JR. is 1740413012 and holds a License No. DT-DO-1003340 (Oregon).

The current practice location address for Anthony Ray Belisle JR. is 965 S 1St St, Coos Bay, OR and can be reached out via phone at 541-267-7278 and via fax at 541-269-4613.

Location: 965 S 1St St, Coos Bay, OR, 97420-0418
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1740413012
Provider Name
Anthony Ray Belisle JR.
Credential
LD
Provider Entity Type
Individual
Gender
Male
Address
965 S 1St St, Coos Bay, OR, 97420-0418
Phone Number
541-267-7278
Fax Number
541-269-4613
Provider Enumeration Date
09/02/2009
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
965 S 1St St
City
Coos Bay
State
Oregon
Zip
97420-1401
Phone Number
541-267-7278
Fax Number
541-269-4613
person
Provider Business Mailing Address Details
Address
965 S 1St St
City
Coos Bay
State
Oregon
Zip
97420-1401
Phone Number
541-267-7278
Fax Number
541-269-4613
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Denturist
Speciality
-
Taxonomy
122400000X
License No.
()
Definition
Definition to come.
person
Provider's Taxonomy Details 2
Type
Dental Providers
Classification
Dental Laboratory Technician
Speciality
-
Taxonomy
126900000X
License No.
DT-DO-1003340 (Oregon)
Definition
An individual who has the skill and knowledge in the fabrication of dental appliances, prostheses and devices in accordance with a dentist's laboratory work authorization. To avoid misleading the public, no occupational title other than dental laboratory technician or certified dental technician (when appropriate) should be used to describe this auxiliary.
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