Provider Demographics
NPI:1437364791
Name:BENET, VICTOR M (DDS)
Entity Type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:M
Last Name:BENET
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 FERRY STREET
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07105
Mailing Address - Country:US
Mailing Address - Phone:973-589-0173
Mailing Address - Fax:973-589-3060
Practice Address - Street 1:30 FERRY STREET
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07105
Practice Address - Country:US
Practice Address - Phone:973-589-0173
Practice Address - Fax:973-589-3060
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJD19407122300000X
NJ22DI01940700122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist