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General NPI Number Information
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NPI Number | 1154781219
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Entity Type | Organization
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Legal Business Name | ERIC BENSON DDS INC
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Dates
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Enumeration Date | 03/02/2016
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Last Update Date | 03/02/2016
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Provider Practice Location Address
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Address Line | 1648 UNION ST STE 202
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City | SAN FRANCISCO
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State | CA
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Zip | 94123-4500
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Country | US
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Telephone | 415-694-0819
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Fax |
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Provider Business Mailing Address
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Address Line | 1648 UNION ST STE 202
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City | SAN FRANCISCO
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State | CA
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Zip | 94123-4500
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Country | US
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Telephone | 415-694-0819
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ERIC BENSON
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Credential | D.D.S.
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Telephone | 415-694-0819
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 51880
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License Number State | CA
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