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General NPI Number Information
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NPI Number | 1720856008
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Entity Type | Individual
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Provider Name | DANIEL BENTALL PA-C
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Gender | Male
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Dates
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Enumeration Date | 12/15/2023
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Last Update Date | 01/16/2026
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Provider Practice Location Address
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Address Line | 101 SHATTUCK WAY STE 6
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City | NEWINGTON
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State | NH
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Zip | 03801-7876
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Country | US
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Telephone | 603-778-9921
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Fax | 603-499-7072
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Provider Business Mailing Address
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Address Line | 49 EPPING RD APT 4
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City | EXETER
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State | NH
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Zip | 03833-1551
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Country | US
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Telephone | 603-801-1257
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State | NH
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