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Benton Family Dentistry LLC

Dentist, General Practice in Benton, LA. Organization (NPI-2).

NPI number1821319476
StatusActive
Last updated in NPPESJun 17, 2010

Details

NPI
1821319476
Entity type
Organization (NPI-2)
Legal business name
Benton Family Dentistry LLC
Organization subpart
No
Enumeration date
Jun 17, 2010
Last updated
Jun 17, 2010

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1223G0001X Dentist, General Practice5793LAYes

Practice location

192 Burt Blvd
Benton, LA 71006-4900

Phone 318-965-2424 · Fax 318-965-0943

Mailing address

Po Box 427
Benton, LA 71006-0427

Phone 318-965-2424 · Fax 318-965-0943

Authorized official

Misty Crump
Dentist
3189652424

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