MEDICARE: DR. MARIA F BENEFIELD D.M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	DN012785	GA

General Provider Information

NPI Number	:	1104093509
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARIA F BENEFIELD D.M.D.

Provider Business Mailing Address
First Line	:	1100 ABERNATHY RD NE
Second Line	:	BUILDING 500 SUITE 1020
City	:	ATLANTA
State	:	GA
Zip	:	30328-5620
Country	:	US
Telephone Number	:	770-804-0616
Fax Number	:	770-804-0520

Provider Business Practice Location Address
First Line	:	1100 ABERNATHY RD NE
Second Line	:	BUILDING 500 SUITE 1020
City	:	ATLANTA
State	:	GA
Zip	:	30328-5620
Country	:	US
Telephone Number	:	770-804-0616
Fax Number	:	770-804-0520

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/14/2008
Last Update Date	:	05/14/2008

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