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General NPI Number Information
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NPI Number | 1336170042
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Entity Type | Organization
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Legal Business Name | BENJAMIN KOREN, D.D.S. III. P.A,
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Dates
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Enumeration Date | 07/05/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 110 W CHURCH ST
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City | CREEDMOOR
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State | NC
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Zip | 27522-9747
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Country | US
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Telephone | 919-528-4004
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Fax | 919-528-2211
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Provider Business Mailing Address
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Address Line | 110 W CHURCH ST
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City | CREEDMOOR
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State | NC
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Zip | 27522-9747
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Country | US
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Telephone | 919-528-4004
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Fax | 919-528-2211
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Authorized Official
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Title or Position | OWNER
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Name | DR. BENJAMIN VICTOR KOREN
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Credential | DDS
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Telephone | 919-528-4004
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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 | 6997
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License Number State | NC
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