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NPI Code Detail

MEDICARE: DR. BENJAMIN LAPKE COENEN DDS

MEDICARE: DR. BENJAMIN LAPKE COENEN DDS
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
11223S0112XOral and Maxillofacial Surgery (Dentist)10890SC

General Provider Information

NPI Number : 1134605728
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BENJAMIN LAPKE COENEN DDS
Provider Business Mailing Address
First Line : 167 REVOLUTION DR
Second Line :
City : MT PLEASANT
State : SC
Zip : 29464-7877
Country : US
Telephone Number : 402-960-7813
Fax Number :
Provider Business Practice Location Address
First Line : 996 TANNER FORD BLVD
Second Line :
City : HANAHAN
State : SC
Zip : 29410-4780
Country : US
Telephone Number : 843-973-8236
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/17/2018
Last Update Date : 10/24/2024

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