Provider Demographics
NPI:1245468842
Name:BENAVENT, VANESSA L (DDS, MSD)
Entity type:Individual
Prefix:DR
First Name:VANESSA
Middle Name:L
Last Name:BENAVENT
Suffix:
Gender:F
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:VANESSA
Other - Middle Name:BENAVENT
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5820 CLARKSVILLE SQUARE DR
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21029-1856
Mailing Address - Country:US
Mailing Address - Phone:443-535-9600
Mailing Address - Fax:443-535-9601
Practice Address - Street 1:5820 CLARKSVILLE SQUARE DR
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21029-1856
Practice Address - Country:US
Practice Address - Phone:443-535-9600
Practice Address - Fax:443-535-9601
Is Sole Proprietor?:No
Enumeration Date:2009-06-23
Last Update Date:2019-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD14555122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No122300000XDental ProvidersDentist