Provider Demographics
NPI:1063828648
Name:. ROBERT F. BENNINGFIELD D.D.S. INC.
Entity Type:Organization
Organization Name:. ROBERT F. BENNINGFIELD D.D.S. INC.
Other - Org Name:ROBERT F. BENNINGFIELD D.D.S. INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:FAULKNER
Authorized Official - Last Name:BENNINGFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:817-249-4150
Mailing Address - Street 1:111 SPROLES DR
Mailing Address - Street 2:
Mailing Address - City:BENBROOK
Mailing Address - State:TX
Mailing Address - Zip Code:76126-3213
Mailing Address - Country:US
Mailing Address - Phone:817-249-4150
Mailing Address - Fax:817-249-4153
Practice Address - Street 1:111 SPROLES DR
Practice Address - Street 2:
Practice Address - City:BENBROOK
Practice Address - State:TX
Practice Address - Zip Code:76126-3213
Practice Address - Country:US
Practice Address - Phone:817-249-4150
Practice Address - Fax:817-249-4153
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-03
Last Update Date:2014-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental