Provider Demographics
NPI:1457550170
Name:BENZLEY, LAYNE (DDS)
Entity Type:Individual
Prefix:DR
First Name:LAYNE
Middle Name:
Last Name:BENZLEY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:753 MALETA LN
Mailing Address - Street 2:SUITE 104
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80108-7605
Mailing Address - Country:US
Mailing Address - Phone:303-660-5373
Mailing Address - Fax:303-660-5374
Practice Address - Street 1:753 MALETA LN
Practice Address - Street 2:SUITE 104
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80108-7605
Practice Address - Country:US
Practice Address - Phone:303-660-5373
Practice Address - Fax:303-660-5374
Is Sole Proprietor?:No
Enumeration Date:2007-07-12
Last Update Date:2010-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO98751223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry