BENTON FAMILY DENTAL PC; NPI #1699154153

Contact Information

BENTON FAMILY DENTAL PC

3299 CLEAR VISTA CT NE, STE A
GRAND RAPIDS, MI 49525

Phone: 616-361-0654
Fax: 616-361-9823
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Dental	261QD0000X

Indicates primary specialty

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NPI Profile & details for BENTON FAMILY DENTAL PC

NPI # 1699154153

LBN Legal business name BENTON FAMILY DENTAL PC

Authorized official STEPHANIE BENTON-LANGEJANS - (PRESIDENT)

Entity Organization

Organization subpart ¹ No

Enumeration date 05/29/2015

Last updated 02/29/2024 - About 2 years ago

Identifiers

License #

014521

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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