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NPI Code Detail

MEDICARE: LAURA BENCA DDS

MEDICARE:   LAURA  BENCA  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
1122300000XDentistDE 60560274WA

General Provider Information

NPI Number : 1528448529
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA BENCA DDS
Provider Business Mailing Address
First Line : 2901 NE BLAKELEY ST APT 211
Second Line :
City : SEATTLE
State : WA
Zip : 98105-3160
Country : US
Telephone Number : 206-919-9701
Fax Number :
Provider Business Practice Location Address
First Line : 2901 NE BLAKELEY ST APT 211
Second Line :
City : SEATTLE
State : WA
Zip : 98105-3160
Country : US
Telephone Number : 206-919-9701
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2015
Last Update Date : 06/04/2015

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Directions to “ LAURA BENCA DDS” Practice Location

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