Provider Demographics
NPI:1821229261
Name:BENZON, JOSEF A (DMD)
Entity Type:Individual
Prefix:
First Name:JOSEF
Middle Name:A
Last Name:BENZON
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 1:6608 KINGS ESTATE DR
Mailing Address - Street 2:
Mailing Address - City:WEST VALLEY CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84128-4225
Mailing Address - Country:US
Mailing Address - Phone:801-518-9254
Mailing Address - Fax:
Practice Address - Street 1:6608 KINGS ESTATE DR
Practice Address - Street 2:
Practice Address - City:WEST VALLEY CITY
Practice Address - State:UT
Practice Address - Zip Code:84128-4225
Practice Address - Country:US
Practice Address - Phone:801-518-9254
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-03
Last Update Date:2009-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7398108-00221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice