Provider Demographics
NPI:1215194147
Name:BATY, BENSON L (DMD)
Entity Type:Individual
Prefix:DR
First Name:BENSON
Middle Name:L
Last Name:BATY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7335 S LEWIS AVE
Mailing Address - Street 2:SUITE 206
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-6845
Mailing Address - Country:US
Mailing Address - Phone:918-496-1051
Mailing Address - Fax:
Practice Address - Street 1:7335 S LEWIS AVE
Practice Address - Street 2:SUITE 206
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-6845
Practice Address - Country:US
Practice Address - Phone:918-496-1051
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-19
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKOK44521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice