Provider Demographics
NPI:1942254305
Name:BENN, DENNIS P (DC)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:P
Last Name:BENN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2284 S BALLENGER HWY
Mailing Address - Street 2:SUITE F
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48503-3446
Mailing Address - Country:US
Mailing Address - Phone:810-235-5181
Mailing Address - Fax:810-235-5190
Practice Address - Street 1:2284 S BALLENGER HWY
Practice Address - Street 2:SUITE F
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48503-3446
Practice Address - Country:US
Practice Address - Phone:810-235-5181
Practice Address - Fax:810-235-5190
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301004346111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIT32772Medicare UPIN
0B55084Medicare ID - Type Unspecified