Individual
SHANNON R. BENEDEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D.H.
Contact information
Practice address
430 MORGAN DR, LEWISTON, NY 14092-1013
(716) 425-6451
(716) 297-0998
Mailing address
430 MORGAN DR, LEWISTON, NY 14092-1013
(716) 425-6451
(716) 297-0998
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
025017
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
025017
NYS LICENSE
NY
Enumeration date
09/05/2008
Last updated
09/05/2008
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