Provider Demographics
NPI:1710192570
Name:MONASTERSKY, BENSON (DMD)
Entity Type:Individual
Prefix:DR
First Name:BENSON
Middle Name:
Last Name:MONASTERSKY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:477 CONNECTICUT BLVD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:EAST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06108-3268
Mailing Address - Country:US
Mailing Address - Phone:860-289-9397
Mailing Address - Fax:860-528-3129
Practice Address - Street 1:110 CONNECTICUT BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:EAST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06108-3057
Practice Address - Country:US
Practice Address - Phone:860-289-9397
Practice Address - Fax:860-528-3129
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT37591223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics