Provider Demographics
NPI:1225031859
Name:BENSCHOTER, DONALD ROBERT (DMD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:ROBERT
Last Name:BENSCHOTER
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 1:1100 SOUTHGATE
Mailing Address - Street 2:SUITE 17
Mailing Address - City:PENDLETON
Mailing Address - State:OR
Mailing Address - Zip Code:97801
Mailing Address - Country:US
Mailing Address - Phone:541-276-1561
Mailing Address - Fax:541-276-5743
Practice Address - Street 1:1100 SOUTHGATE
Practice Address - Street 2:SUITE 17
Practice Address - City:PENDLETON
Practice Address - State:OR
Practice Address - Zip Code:97801
Practice Address - Country:US
Practice Address - Phone:541-276-1561
Practice Address - Fax:541-276-5743
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-05-27
Last Update Date:2007-07-08
Deactivation Date:2006-03-25
Deactivation Code:
Reactivation Date:2006-04-11
Provider Licenses
StateLicense IDTaxonomies
OR52691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice