Provider Demographics
NPI:1033495817
Name:PETER ANDREW BENSON DDS, PC
Entity Type:Organization
Organization Name:PETER ANDREW BENSON DDS, PC
Other - Org Name:DENTISTRY FOR ADULTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:BENSON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:972-981-8653
Mailing Address - Street 1:6300 W PARKER RD STE 223
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-8102
Mailing Address - Country:US
Mailing Address - Phone:972-981-8653
Mailing Address - Fax:972-981-8655
Practice Address - Street 1:6300 W PARKER RD STE 223
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8102
Practice Address - Country:US
Practice Address - Phone:972-981-8653
Practice Address - Fax:972-981-8655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-25
Last Update Date:2011-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX22847261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental