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Individual
DR. BENNETT C PACKARD
Active
Individual
DR. BENNETT C PACKARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8467
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
141990582
ADA
WA
01
—
170386
LABOR & INDUSTRIES
WA
05
—
5032214
—
WA
01
—
8467
STATE LICENSE
WA
01
—
8923821
CRIME VICTIMS
WA
01
—
898780
UNITED CONCORDIA
WA
01
—
92560941
TPIN
WA
Enumeration date
10/10/2006
Last updated
03/07/2023
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