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General NPI Number Information
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NPI Number | 1477260750
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Entity Type | Organization
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Legal Business Name | BENSON DENTAL LLC
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Dates
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Enumeration Date | 11/04/2022
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Last Update Date | 11/04/2022
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Provider Practice Location Address
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Address Line | 1404 FORD AVNUE
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City | WYANDOTTE
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State | MI
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Zip | 48192
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Country | US
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Telephone | 734-285-2575
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Fax | 734-285-2758
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Provider Business Mailing Address
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Address Line | 1404 FORD AVENUE
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City | WYANDOTTE
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State | MI
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Zip | 48192
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Country | US
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Telephone | 734-285-2575
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Fax | 734-285-2758
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Authorized Official
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Title or Position | OWNER/SENTIST
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Name | HUSSEIN DAGHER
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Credential | D.S.S.
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Telephone | 734-285-2575
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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 |
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License Number State |
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