Provider Demographics
NPI:1609191352
Name:BENTON, BRANDON KYLE (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:KYLE
Last Name:BENTON
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 1:2220 MALVERN AVE
Mailing Address - Street 2:STE B
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71901-8038
Mailing Address - Country:US
Mailing Address - Phone:501-623-6132
Mailing Address - Fax:
Practice Address - Street 1:2220 MALVERN AVE
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71901-8038
Practice Address - Country:US
Practice Address - Phone:501-991-9132
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-06
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR37161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice