Provider Demographics
NPI:1366672065
Name:BENTON, CHRISTOPHER BENNETT (DMD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:BENNETT
Last Name:BENTON
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 1:157 PORTSMOUTH AVE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:STRATHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03885-2477
Mailing Address - Country:US
Mailing Address - Phone:603-772-3264
Mailing Address - Fax:
Practice Address - Street 1:157 PORTSMOUTH AVE
Practice Address - Street 2:SUITE 4
Practice Address - City:STRATHAM
Practice Address - State:NH
Practice Address - Zip Code:03885-2477
Practice Address - Country:US
Practice Address - Phone:603-772-3264
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-16
Last Update Date:2015-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH037831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice