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General NPI Number Information
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NPI Number | 1124683461
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Entity Type | Organization
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Legal Business Name | VANESSA BENAVENT, DDS, MSD, FAGD
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Dates
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Enumeration Date | 05/02/2019
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Last Update Date | 05/02/2019
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Provider Practice Location Address
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Address Line | 5820 CLARKSVILLE SQUARE DR
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City | CLARKSVILLE
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State | MD
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Zip | 21029-1856
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Country | US
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Telephone | 443-535-9600
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Fax | 443-535-9601
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Provider Business Mailing Address
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Address Line | 5820 CLARKSVILLE SQUARE DR
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City | CLARKSVILLE
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State | MD
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Zip | 21029-1856
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Country | US
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Telephone | 443-535-9600
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Fax | 443-535-9601
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Authorized Official
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Title or Position | OWNER
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Name | DR. VANESSA BENAVENT ANDERSON
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Credential | DDS, MSD
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Telephone | 443-535-9600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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