Provider Demographics
NPI:1356917116
Name:HARWOOD, BENJAMIN EDWARD (DMD)
Entity type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:EDWARD
Last Name:HARWOOD
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PORTER
Mailing Address - State:ME
Mailing Address - Zip Code:04068-3527
Mailing Address - Country:US
Mailing Address - Phone:207-625-8551
Mailing Address - Fax:
Practice Address - Street 1:38 MAIN ST
Practice Address - Street 2:
Practice Address - City:PORTER
Practice Address - State:ME
Practice Address - Zip Code:04068-3527
Practice Address - Country:US
Practice Address - Phone:207-625-8551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-02
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEDEN48811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice