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General NPI Number Information
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NPI Number | 1871834192
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Entity Type | Organization
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Legal Business Name | H HERBERT BENAVENT DDS PA
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Dates
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Enumeration Date | 03/12/2013
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Last Update Date | 03/12/2013
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Provider Practice Location Address
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Address Line | 5820 CLARKSVILLE SQUARE DR
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City | CLARKSVILLE
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State | MD
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Zip | 21029-1856
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Country | US
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Telephone | 443-535-9600
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Fax | 443-535-9601
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Provider Business Mailing Address
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Address Line | 5820 CLARKSVILLE SQUARE DR
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City | CLARKSVILLE
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State | MD
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Zip | 21029-1856
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Country | US
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Telephone | 443-535-9600
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Fax | 443-535-9601
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Authorized Official
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Title or Position | DENTIST
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Name | DR. HARRY HERBERT BENAVENT
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Credential | DDS
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Telephone | 443-535-9600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 13620
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License Number State | MD
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