Individual
DR. BENJAMIN CLINKENBEARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3615 LAKE AVE, FORT WAYNE, IN 46805-5539
(260) 615-9177
(260) 615-9177
Mailing address
3615 LAKE AVE, FORT WAYNE, IN 46805-5539
(260) 615-9177
(260) 615-9177
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12010541A
IN
Other
Enumeration date
09/26/2006
Last updated
09/29/2009
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