Individual
DR. DALE BENJAMIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
6020 W DIVERSEY AVE, CHICAGO, IL 60639-1108
(773) 237-0707
Mailing address
2000 W HURON ST # 2, CHICAGO, IL 60612-1304
(352) 284-4164
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019028101
IL
Other
Enumeration date
10/28/2010
Last updated
10/28/2010
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