Provider Demographics
NPI:1720070857
Name:BENOV, ALAN S (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:S
Last Name:BENOV
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 1:5151 N PALM AVE
Mailing Address - Street 2:SUITE 70
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93704-2211
Mailing Address - Country:US
Mailing Address - Phone:559-224-1646
Mailing Address - Fax:
Practice Address - Street 1:5151 N PALM AVE
Practice Address - Street 2:SUITE 70
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93704-2211
Practice Address - Country:US
Practice Address - Phone:559-224-1646
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA214291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice