Provider Demographics
NPI:1164611315
Name:WILLIAM T BENSON DMD PC
Entity Type:Organization
Organization Name:WILLIAM T BENSON DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:T
Authorized Official - Last Name:BENSON
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:978-372-9122
Mailing Address - Street 1:215 SUMMER STREET
Mailing Address - Street 2:SUITE 11
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01830
Mailing Address - Country:US
Mailing Address - Phone:978-372-9122
Mailing Address - Fax:978-372-6131
Practice Address - Street 1:215 SUMMER STREET
Practice Address - Street 2:SUITE 11
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01830
Practice Address - Country:US
Practice Address - Phone:978-372-9122
Practice Address - Fax:978-372-6131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-23
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA156951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty