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General NPI Number Information
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NPI Number | 1962443663
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Entity Type | Organization
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Legal Business Name | RICHARD L BENNETT DDS PA
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Dates
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Enumeration Date | 06/10/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 909 COMMERCIAL ST
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City | EMPORIA
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State | KS
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Zip | 66801
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Country | US
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Telephone | 620-343-9220
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Fax | 620-343-9221
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Provider Business Mailing Address
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Address Line | 909 COMMERCIAL ST
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City | EMPORIA
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State | KS
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Zip | 66801
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Country | US
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Telephone | 620-343-9220
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Fax | 620-343-9221
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Authorized Official
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Title or Position | DENTIST
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Name | DR. RICHARD L BENNETT
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Credential | DDS
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Telephone | 620-343-9220
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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 | 4308
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 6600
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License Number State | KS
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