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General NPI Number Information
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NPI Number | 1265480909
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Entity Type | Individual
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Provider Name | BENJAMIN L. STUDEBAKER DMD, MSD
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Gender | Male
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Dates
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Enumeration Date | 05/05/2006
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Last Update Date | 08/14/2015
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Provider Practice Location Address
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Address Line | 18631 ALDERWOOD MALL PKWY SUITE 203
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City | LYNNWOOD
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State | WA
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Zip | 98037-8014
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Country | US
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Telephone | 425-672-3737
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Fax | 425-672-1309
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Provider Business Mailing Address
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Address Line | 18631 ALDERWOOD MALL PKWY SUITE 203
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City | LYNNWOOD
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State | WA
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Zip | 98037-8014
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Country | US
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Telephone | 425-672-3737
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Fax | 425-672-1309
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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 | DE 60548418
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License Number State | WA
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