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General NPI Number Information
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NPI Number | 1619560257
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Entity Type | Organization
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Legal Business Name | BEN DANIEL DMD, PA
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Dates
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Enumeration Date | 02/15/2021
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Last Update Date | 02/15/2021
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Provider Practice Location Address
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Address Line | 2104B WOODRUFF RD
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City | GREENVILLE
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State | SC
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Zip | 29607-5941
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Country | US
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Telephone | 864-254-6414
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Fax | 864-254-6454
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Provider Business Mailing Address
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Address Line | 2104B WOODRUFF RD
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City | GREENVILLE
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State | SC
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Zip | 29607-5941
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Country | US
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Telephone | 864-254-6414
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Fax | 864-254-6454
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BENJAMIN DANIEL
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Credential | DMD
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Telephone | 864-254-6414
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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