# DANA R BENNETT MD PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407063563
- **Authorized official:** MRS. PATTI F BENNETT (OFFICE MGR)
- **Authorized official phone:** (719) 547-3924

## Contact information

- **Practice address:** 121 S CRESCENT DR, PUEBLO WEST, CO 81007-5433
- **Practice address phone:** (719) 547-3924
- **Practice address fax:** (719) 547-8368
- **Mailing address:** 121 S CRESCENT DR, PUEBLO WEST, CO 81007-5433
- **Mailing address phone:** (719) 547-3924
- **Mailing address fax:** (719) 547-8368

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 21659 | CO | Yes |

## Other

- **Enumeration date:** 05/17/2007
- **Last updated:** 03/07/2008