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Individual
DR. NATHANAEL DAVID BENASSI
Active
Individual
DR. NATHANAEL DAVID BENASSI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
019.029572
IL
1223P0221X
Pediatric Dentistry
Primary
1002348
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
019-029572
IL STATE DENTAL LICENSE
IL
Enumeration date
08/13/2013
Last updated
04/28/2022
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