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General NPI Number Information
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NPI Number | 1255684916
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Entity Type | Individual
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Provider Name | BENJAMIN ERIC PORRAS D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/18/2012
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Last Update Date | 09/21/2025
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Provider Practice Location Address
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Address Line | 4603 OLEANDER DR STE 6
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City | MYRTLE BEACH
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State | SC
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Zip | 29577-5738
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Country | US
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Telephone | 843-492-7979
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Fax |
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Provider Business Mailing Address
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Address Line | 584 STARLIT WAY
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City | MYRTLE BEACH
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State | SC
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Zip | 29579-4322
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Country | US
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Telephone |
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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 | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 9688
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN19858
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | DEN1001861
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License Number State | DC
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