Dr. Benjamin J Gardner, D.D.S.
Dentist in Winslow, AZ. Individual provider (NPI-1).
NPI number1457799488
StatusActive
Last updated in NPPESJun 12, 2013
Details
- NPI
- 1457799488
- Entity type
- Individual (NPI-1)
- Name
- Dr. Benjamin J Gardner
- Credential
- D.D.S.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jun 12, 2013
- Last updated
- Jun 12, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | D008660 | AZ | Yes |
Practice location
500 N Indiana AveWinslow, AZ 86047
Phone 928-289-6226
Mailing address
4255 E Soliere Ave Apt 215Flagstaff, AZ 86004-7930
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