Provider Demographics
NPI:1750935219
Name:DON, BENJAMIN (DMD)
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:
Last Name:DON
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 1:1757 N SWAN RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-3501
Mailing Address - Country:US
Mailing Address - Phone:520-795-7733
Mailing Address - Fax:
Practice Address - Street 1:4015 E PARADISE FALLS DR STE 129
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-6701
Practice Address - Country:US
Practice Address - Phone:520-909-9130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-01
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD0108771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice