Provider Demographics
NPI:1477260750
Name:BENSON DENTAL LLC
Entity Type:Organization
Organization Name:BENSON DENTAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SENTIST
Authorized Official - Prefix:
Authorized Official - First Name:HUSSEIN
Authorized Official - Middle Name:
Authorized Official - Last Name:DAGHER
Authorized Official - Suffix:
Authorized Official - Credentials:DSS
Authorized Official - Phone:734-285-2575
Mailing Address - Street 1:1404 FORD AVENUE
Mailing Address - Street 2:
Mailing Address - City:WYANDOTTE
Mailing Address - State:MI
Mailing Address - Zip Code:48192
Mailing Address - Country:US
Mailing Address - Phone:734-285-2575
Mailing Address - Fax:734-285-2758
Practice Address - Street 1:1404 FORD AVNUE
Practice Address - Street 2:
Practice Address - City:WYANDOTTE
Practice Address - State:MI
Practice Address - Zip Code:48192
Practice Address - Country:US
Practice Address - Phone:734-285-2575
Practice Address - Fax:734-285-2758
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-04
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty