Provider Demographics
NPI:1891132585
Name:DONN, BENJAMIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:
Last Name:DONN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:BENJAMIN
Other - Middle Name:
Other - Last Name:DONN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:202 E CHEYENNE MOUNTAIN BLVD STE E
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-3769
Mailing Address - Country:US
Mailing Address - Phone:719-576-6551
Mailing Address - Fax:719-576-8722
Practice Address - Street 1:202 E CHEYENNE MOUNTAIN BLVD STE E
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-3769
Practice Address - Country:US
Practice Address - Phone:719-576-6551
Practice Address - Fax:719-576-8722
Is Sole Proprietor?:No
Enumeration Date:2013-06-04
Last Update Date:2015-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.00201990122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist