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General NPI Number Information
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NPI Number | 1427250570
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Entity Type | Individual
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Provider Name | BEN R DANSIE DMD
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Gender | Male
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Dates
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Enumeration Date | 06/01/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 130 N 1ST W
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City | RIGBY
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State | ID
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Zip | 83442-1377
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Country | US
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Telephone | 208-745-6591
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Fax |
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Provider Business Mailing Address
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Address Line | 130 NORTH 1ST WEST
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City | RIGBY
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State | ID
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Zip | 83442
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Country | US
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Telephone | 208-745-6591
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | D4055
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License Number State | ID
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