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General NPI Number Information
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NPI Number | 1750505046
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Entity Type | Individual
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Provider Name | BENJAMIN F CONTRERAS DENTIST
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Gender | Male
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Dates
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Enumeration Date | 04/11/2007
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Last Update Date | 01/07/2014
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Provider Practice Location Address
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Address Line | 1027 MAIN ST SUITE A
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City | PASADENA
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State | TX
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Zip | 77506-4538
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Country | US
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Telephone | 713-472-8419
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Fax | 713-472-0344
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Provider Business Mailing Address
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Address Line | 4525 HOLLY ST
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City | BELLAIRE
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State | TX
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Zip | 77401-5802
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Country | US
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Telephone | 713-906-7901
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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 | 17135
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License Number State | TX
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