Provider Demographics
NPI:1386854230
Name:DANNIE G. BENJAMIN, JR. D.D.S. JAMES H. GUDGER D.D. S.
Entity Type:Organization
Organization Name:DANNIE G. BENJAMIN, JR. D.D.S. JAMES H. GUDGER D.D. S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:H
Authorized Official - Last Name:GUDGER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:704-825-9635
Mailing Address - Street 1:PO BOX 507
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:NC
Mailing Address - Zip Code:28012-0507
Mailing Address - Country:US
Mailing Address - Phone:704-825-9635
Mailing Address - Fax:704-825-9636
Practice Address - Street 1:203 S MAIN ST
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:NC
Practice Address - Zip Code:28012-3831
Practice Address - Country:US
Practice Address - Phone:704-825-9635
Practice Address - Fax:704-825-9636
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty