Provider Demographics
NPI:1942322805
Name:WESTON, BENJAMIN DALE (DDS)
Entity Type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:DALE
Last Name:WESTON
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 1:6161-A LAKE BRANDT RD
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27455
Mailing Address - Country:US
Mailing Address - Phone:336-643-1440
Mailing Address - Fax:336-643-1440
Practice Address - Street 1:6161-A LAKE BRANDT RD
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27455
Practice Address - Country:US
Practice Address - Phone:336-643-1440
Practice Address - Fax:336-643-1440
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2010-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC68911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice