Provider Demographics
NPI:1942402326
Name:BARTLEY H BENSON DDS MS PC
Entity Type:Organization
Organization Name:BARTLEY H BENSON DDS MS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHODONTIST PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BARTLEY
Authorized Official - Middle Name:HOWELL
Authorized Official - Last Name:BENSON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS MS
Authorized Official - Phone:615-885-1349
Mailing Address - Street 1:PO BOX 8
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37076
Mailing Address - Country:US
Mailing Address - Phone:615-885-1349
Mailing Address - Fax:615-871-0726
Practice Address - Street 1:4243 LEBANON RD
Practice Address - Street 2:SUITE C
Practice Address - City:HERMITAGE
Practice Address - State:TN
Practice Address - Zip Code:37076
Practice Address - Country:US
Practice Address - Phone:615-885-1349
Practice Address - Fax:615-871-0726
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS00000046391223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty