Individual
MICHAEL WILLIAM BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
200 HAWKINS DR, IOWA CITY, IA 52242-1009
(319) 356-1616
Mailing address
200 HAWKINS DR, IOWA CITY, IA 52242-1009
(630) 988-0762
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/23/2012
Last updated
07/09/2012
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