Individual
DR. KIRK BENNEWITZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
500 DAVIS ST, #504, EVANSTON, IL 60201-4668
(847) 491-1011
Mailing address
500 DAVIS ST, #504, EVANSTON, IL 60201-4668
(847) 491-1011
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019017116
IL
Other
Enumeration date
07/28/2008
Last updated
07/28/2008
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