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General NPI Number Information
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NPI Number | 1881082253
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Entity Type | Organization
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Legal Business Name | DR GERALD C BENJAMIN
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Dates
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Enumeration Date | 01/07/2015
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Last Update Date | 01/07/2015
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Provider Practice Location Address
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Address Line | 18 DIVISION ST
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City | SARATOGA SPRINGS
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State | NY
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Zip | 12866-2188
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Country | US
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Telephone | 518-583-1116
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Fax |
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Provider Business Mailing Address
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Address Line | 18 DIVISION ST
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City | SARATOGA SPRINGS
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State | NY
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Zip | 12866-2188
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Country | US
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Telephone | 518-583-1116
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GERALD BENJAMIN
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Credential | DDS
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Telephone | 518-583-1116
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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 | 032953
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License Number State | NY
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