Provider Demographics
NPI:1720376981
Name:PLANK, BENJAMIN TROYER (DDS)
Entity Type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:TROYER
Last Name:PLANK
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 1:1700 S 1ST AVE
Mailing Address - Street 2:SUITE #29
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52240-6036
Mailing Address - Country:US
Mailing Address - Phone:319-338-9761
Mailing Address - Fax:
Practice Address - Street 1:1700 S 1ST AVE
Practice Address - Street 2:SUITE #29
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52240-6036
Practice Address - Country:US
Practice Address - Phone:319-338-9761
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-21
Last Update Date:2013-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA088431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice