Provider Demographics
NPI:1255599684
Name:BENJAMIN-BRANDT, KERRI S (DDS)
Entity type:Individual
Prefix:
First Name:KERRI
Middle Name:S
Last Name:BENJAMIN-BRANDT
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1506 AMHERST PL SW
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-8634
Mailing Address - Country:US
Mailing Address - Phone:740-654-2010
Mailing Address - Fax:740-654-2915
Practice Address - Street 1:1506 AMHERST PL SW
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-8634
Practice Address - Country:US
Practice Address - Phone:740-654-2010
Practice Address - Fax:740-654-2915
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-02
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH209731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice