Provider Demographics
NPI:1942460936
Name:BENNER & SHARP FAMILY DENTISTRY
Entity Type:Organization
Organization Name:BENNER & SHARP FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARP
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:970-351-0400
Mailing Address - Street 1:3400 W 16TH ST
Mailing Address - Street 2:SUITE 8-E
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80634-6862
Mailing Address - Country:US
Mailing Address - Phone:970-351-0400
Mailing Address - Fax:
Practice Address - Street 1:3400 W 16TH ST
Practice Address - Street 2:SUITE 8-E
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-6862
Practice Address - Country:US
Practice Address - Phone:970-351-0400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-12
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO8674122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty