Provider Demographics
NPI:1477710390
Name:BENNION, KRISTOPHER K (DMD)
Entity type:Individual
Prefix:DR
First Name:KRISTOPHER
Middle Name:K
Last Name:BENNION
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 1:751 BEST DR STE D
Mailing Address - Street 2:
Mailing Address - City:SEGUIN
Mailing Address - State:TX
Mailing Address - Zip Code:78155-3637
Mailing Address - Country:US
Mailing Address - Phone:830-209-7262
Mailing Address - Fax:830-209-7263
Practice Address - Street 1:751 BEST DR STE D
Practice Address - Street 2:
Practice Address - City:SEGUIN
Practice Address - State:TX
Practice Address - Zip Code:78155-3637
Practice Address - Country:US
Practice Address - Phone:830-209-7262
Practice Address - Fax:830-209-7263
Is Sole Proprietor?:No
Enumeration Date:2008-05-19
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS037152122300000X
TX241551223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist