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General NPI Number Information
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NPI Number | 1497024194
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Entity Type | Organization
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Legal Business Name | ERIC BENSON DDS LLC
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Dates
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Enumeration Date | 12/26/2011
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Last Update Date | 08/17/2015
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Provider Practice Location Address
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Address Line | 774 ELMGROVE RD
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City | ROCHESTER
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State | NY
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Zip | 14624-1318
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Country | US
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Telephone | 585-426-0810
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Fax | 585-426-0479
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Provider Business Mailing Address
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Address Line | 774 ELMGROVE RD
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City | ROCHESTER
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State | NY
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Zip | 14624-1318
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Country | US
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Telephone | 585-426-0810
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Fax | 585-426-0479
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Authorized Official
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Title or Position | MEMBER
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Name | DR. ERIC E BENSON
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Credential | DDS
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Telephone | 585-426-0810
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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 | 048127
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License Number State | NY
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