MEDICARE: DR. HERBERT DANIEL BENKEL D.D.S.

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	1223E0200X	Endodontics	22DI01116700	NJ

General Provider Information

NPI Number	:	1538244520
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HERBERT DANIEL BENKEL D.D.S.

Provider Business Mailing Address
First Line	:	80 GRAND AVE
Second Line	:
City	:	RIVER EDGE
State	:	NJ
Zip	:	07661-1914
Country	:	US
Telephone Number	:	201-487-5444
Fax Number	:	201-487-3853

Provider Business Practice Location Address
First Line	:	80 GRAND AVE
Second Line	:
City	:	RIVER EDGE
State	:	NJ
Zip	:	07661-1914
Country	:	US
Telephone Number	:	201-487-5444
Fax Number	:	201-487-3853

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

Provider Enumeration Date	:	10/26/2006
Last Update Date	:	07/08/2007

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