National Provider Identifier Database

BENSON ORAL SURGERY AND DENTAL IMPLANTS LLC
Oral and Maxillofacial Surgery

The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.


Contact Information

BENSON ORAL SURGERY AND DENTAL IMPLANTS, LLC
8809 W 400 N
SUITE 2
MICHIGAN CITY, IN46360-9330
Phone: 219-879-8710
Fax:
Website:
Specialty Taxonomy Code
* Oral and Maxillofacial Surgery 261QS0112X

* Indicates primary specialty

NPI Profile & details for BENSON ORAL SURGERY AND DENTAL IMPLANTS, LLC

NPI Number 1740548015
Legal business name
LBN
BENSON ORAL SURGERY AND DENTAL IMPLANTS, LLC
Authorized official GREGORY BENSON - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 04/24/2012
Last updated 04/24/2012 - About 14 years ago
Sole proprietor1 Not specified
Identifiers
  • IN License #: 12011706A
  • IN Medicaid: 201031920A
  • WI Medicaid: 33791200

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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