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NPI 1851467393

NPI 1851467393 : KRISTEN LEIGH BENES D.D.S., M.S. : PEORIA, AZ

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General NPI Number Information
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    NPI Number           |    1851467393
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    Entity Type          |    Individual 
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    Provider Name        |    KRISTEN LEIGH BENES D.D.S., M.S.
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    11/27/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    15188 N 75TH AVE SUITE 280
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    City                 |    PEORIA
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    State                |    AZ
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    Zip                  |    85381-4723
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    Country              |    US
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    Telephone            |    623-979-8530
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    Fax                  |    623-979-8192
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Provider Business Mailing Address
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    Address Line         |    5112 E SIERRA SUNSET TRL 
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    City                 |    CAVE CREEK
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    State                |    AZ
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    Zip                  |    85331-4502
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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    |    
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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        |    1223X0400X
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    Taxonomy Name        |    Orthodontics and Dentofacial Orthopedics Dentistry
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    License Number       |    5980
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    License Number State |    AZ
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