Provider Demographics
NPI:1891714184
Name:SUMLIN, BENJAMIN HOWARD (DDS)
Entity Type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:HOWARD
Last Name:SUMLIN
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 1:1013 CHESTNUT LN
Mailing Address - Street 2:SUITE #230
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28104-8566
Mailing Address - Country:US
Mailing Address - Phone:704-684-0447
Mailing Address - Fax:704-684-1334
Practice Address - Street 1:1013 CHESTNUT LN
Practice Address - Street 2:SUITE #230
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28104-8566
Practice Address - Country:US
Practice Address - Phone:704-684-0447
Practice Address - Fax:704-684-1334
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2008-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC74931223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice