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Individual
MRS. MARISSA N. BENDER
Active
Individual
MRS. MARISSA N. BENDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD, MBA
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE00009155
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01606946
UNITED CONCORDIA PROVIDER
WA
01
—
28641
WASHINGTON DENTAL SERVICE
WA
01
—
48726
DHA PRACTICE ID
WA
05
—
5046057
—
WA
01
—
51909
DHA/FORTIS PROVIDER ID
WA
01
—
5582BE
REGENCE BLUESHIELD
WA
Enumeration date
05/15/2006
Last updated
08/13/2007
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