Provider Demographics
NPI:1043535727
Name:DR. B. KYLE BENTON, DDS, PA
Entity Type:Organization
Organization Name:DR. B. KYLE BENTON, DDS, PA
Other - Org Name:BENTON FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GENERAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:KYLE
Authorized Official - Last Name:BENTON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:501-623-6132
Mailing Address - Street 1:2220 MALVERN AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71901-8038
Mailing Address - Country:US
Mailing Address - Phone:501-623-6132
Mailing Address - Fax:
Practice Address - Street 1:2220 MALVERN AVE
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71901-8038
Practice Address - Country:US
Practice Address - Phone:501-991-9132
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-06
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR37161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty