Provider Demographics
NPI:1548426000
Name:BENNINGFIELD, ROBERT F (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:F
Last Name:BENNINGFIELD
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 1:111 SPROLES DR
Mailing Address - Street 2:
Mailing Address - City:BENBROOK
Mailing Address - State:TX
Mailing Address - Zip Code:76126-3213
Mailing Address - Country:US
Mailing Address - Phone:817-249-4150
Mailing Address - Fax:817-249-4150
Practice Address - Street 1:111 SPROLES DR
Practice Address - Street 2:
Practice Address - City:BENBROOK
Practice Address - State:TX
Practice Address - Zip Code:76126-3213
Practice Address - Country:US
Practice Address - Phone:817-249-4150
Practice Address - Fax:817-249-4150
Is Sole Proprietor?:No
Enumeration Date:2008-08-04
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX118791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice