Provider Demographics
NPI:1134290216
Name:BENSIMON, MARC (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARC
Middle Name:
Last Name:BENSIMON
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 1:201 EASTERN PKWY
Mailing Address - Street 2:SUITE 2-A
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11238-6141
Mailing Address - Country:US
Mailing Address - Phone:718-636-5666
Mailing Address - Fax:
Practice Address - Street 1:11109 76TH RD
Practice Address - Street 2:SUITE A-5
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-6424
Practice Address - Country:US
Practice Address - Phone:718-268-3222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0381831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice