Provider Demographics
NPI:1043230295
Name:RAMIREZ, BENIGNO (DDS)
Entity Type:Individual
Prefix:DR
First Name:BENIGNO
Middle Name:
Last Name:RAMIREZ
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2057
Mailing Address - Street 2:
Mailing Address - City:BUNNELL
Mailing Address - State:FL
Mailing Address - Zip Code:32110-2057
Mailing Address - Country:US
Mailing Address - Phone:386-437-0380
Mailing Address - Fax:386-437-2297
Practice Address - Street 1:507 EAST MOODY BOULEVARD
Practice Address - Street 2:
Practice Address - City:BUNNELL
Practice Address - State:FL
Practice Address - Zip Code:32110
Practice Address - Country:US
Practice Address - Phone:386-437-0380
Practice Address - Fax:386-437-2297
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 125811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice