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General NPI Number Information
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NPI Number | 1780481804
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Entity Type | Organization
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Legal Business Name | DENTISTS OF NAMPA, PC
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Dates
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Enumeration Date | 02/26/2025
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Last Update Date | 02/26/2025
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Provider Practice Location Address
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Address Line | 1255 N HAPPY VALLEY RD STE 120
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City | NAMPA
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State | ID
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Zip | 83687-5781
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Country | US
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Telephone | 208-563-2724
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 660041
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City | DALLAS
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State | TX
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Zip | 75266-0041
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KENNETH BENSON
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Credential |
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Telephone | 714-845-8500
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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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