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General NPI Number Information
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NPI Number | 1326102849
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Entity Type | Individual
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Provider Name | MELVIN BURNETT BENSON JR. DDS
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Gender | Male
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Dates
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Enumeration Date | 12/20/2006
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Last Update Date | 08/23/2022
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Provider Practice Location Address
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Address Line | 1435 S TAMIAMI TRL STE B
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City | SARASOTA
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State | FL
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Zip | 34239-2946
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Country | US
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Telephone | 941-425-6367
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Fax | 941-363-6393
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Provider Business Mailing Address
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Address Line | 1435 S TAMIAMI TRL STE B
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City | SARASOTA
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State | FL
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Zip | 34239-2946
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Country | US
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Telephone | 941-256-3675
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Fax | 941-363-6393
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 5858
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License Number State | OK
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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 | 9315
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN26712
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License Number State | FL
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