Mark Richard Benne DDS

NPI 1104806041 - Dentist - 1223G0001X

NPI Details
NPI 1104806041
Gender Male
Enumeration Date 01/18/2006
Last Updated 05/27/2016
Entity Type Individual
Active Over 11 years ago
Practice Location
1631 WETZEL AVE
BLDG 815
FORT CARSON CO, 80913-4095, US
Phone (719) 526-5537
Fax (719) 524-2843
Business Location
1631 WETZEL AVE
BLDG 815
FORT CARSON CO, 80913-4095, US
Phone (719) 526-5537
Fax (719) 524-2843
Toxanomy
Taxonomy Code 1223G0001X
License State California
License Number 53740
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According to our database, Dr. Mark Richard Benne DDS NPI is 1104806041, taxonomy code is 1223G0001X and license number is 53740, license state is located at California. Mark Richard Benne DDS physically located at 1631 Wetzel Ave, Fort Carson CO, 80913-4095. NPI Number Mark Richard Benne DDS has the Individual type.

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1104806041 NPI number is provided on an as is basis without warranty of any kind. 1104806041 is maintained by the National Plan & Provider Enumeration System. The contents of Mark Richard Benne DDS are for informational purposes only.