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General NPI Number Information
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NPI Number | 1861046377
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Entity Type | Organization
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Legal Business Name | NANNETTE BENEDICT DDS ASSOCIATES
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Dates
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Enumeration Date | 08/01/2019
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Last Update Date | 08/01/2019
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Provider Practice Location Address
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Address Line | 5015 SCOTTS VALLEY DRIVE
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City | SCOTTS VALLEY
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State | CA
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Zip | 95066
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Country | US
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Telephone | 831-440-9214
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Fax | 831-438-6412
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Provider Business Mailing Address
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Address Line | 5015 SCOTTS VALLEY DRIVE
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City | SCOTTS VALLEY
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State | CA
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Zip | 95066
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Country | US
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Telephone | 831-440-9214
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Fax | 831-438-6412
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. JOAN RITA RIPPE
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Credential |
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Telephone | 831-440-9214
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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