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Contact Information

BENJAMIN N BELLAVANCE
23RD DENTAL COMPANY 1591 GRIFFIN ROAD
TWENTYNINE PALMS, CA92278
 Phone: 760-830-7054
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dentist

122300000X
 

Student Health

261QS1000X
Indicates primary specialty

NPI Profile & details for BENJAMIN N BELLAVANCE · (Male)

NPI # 1386406999
Status Active
Credentials
Entity Individual
Enumeration date 01/29/2024
Last updated 07/22/2025 - About 11 months ago
Sole proprietor 1 Yes
Identifiers
  • UT License # 14231492-9926
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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