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General NPI Number Information
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NPI Number | 1215958053
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Entity Type | Individual
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Provider Name | DEAN R BENNETT MD
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Gender | Male
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Dates
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Enumeration Date | 07/21/2006
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Last Update Date | 03/29/2011
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Provider Practice Location Address
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Address Line | 13350 FRANKLIN FARM ROAD SUITE 220
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City | HERNDON
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State | VA
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Zip | 20171
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Country | US
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Telephone | 703-471-5300
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Fax | 703-471-4391
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Provider Business Mailing Address
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Address Line | PO BOX 71230
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City | PHILADELPHIA
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State | PA
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Zip | 19176-6230
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Country | US
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Telephone | 703-383-6424
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 0101036600
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License Number State | VA
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