# JOHN W BENTON MD PA

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

## Provider details

- **NPI number:** 1891824553
- **Authorized official:** JOHN W BENTON MD (PRESIDENT)
- **Authorized official phone:** (651) 379-2772

## Contact information

- **Practice address:** 1600 UNIVERSITY AVENUE WEST, SUITE 306, ST PAUL, MN 55104
- **Practice address phone:** (651) 379-2772
- **Practice address fax:** (651) 379-2774
- **Mailing address:** 1600 UNIVERSITY AVENUE WEST, SUITE 306, ST PAUL, MN 55104
- **Mailing address phone:** (651) 379-2772
- **Mailing address fax:** (651) 379-2774

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | 18127 | MN | Yes |

## Other

- **Enumeration date:** 03/05/2007
- **Last updated:** 08/22/2020