MEDICARE: DR. NEVILLE BENJAMIN DDS, MSC.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	9545	FL

General Provider Information

NPI Number	:	1457560856
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NEVILLE BENJAMIN DDS, MSC.D

Provider Business Mailing Address
First Line	:	470 COLUMBIA DR
Second Line	:	SUITE D 101
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33409-1997
Country	:	US
Telephone Number	:	561-640-9200
Fax Number	:	561-640-9204

Provider Business Practice Location Address
First Line	:	470 COLUMBIA DR
Second Line	:	SUITE D 101
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33409-1997
Country	:	US
Telephone Number	:	561-640-9200
Fax Number	:	561-640-9204

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

Provider Enumeration Date	:	05/22/2007
Last Update Date	:	07/08/2007

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