Individual
DR. CHASE ALAN BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
5230 CARROLL CANYON RD STE 326, SAN DIEGO, CA 92121-1781
(619) 494-5091
(619) 881-0408
Mailing address
5230 CARROLL CANYON RD STE 326, SAN DIEGO, CA 92121-1781
(619) 494-5091
(619) 881-0408
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
202272
CO
122300000X
Dentist
61279
CA
122300000X
Dentist
DD261279
CA
174400000X
Specialist
202272
CO
174400000X
Specialist
Primary
61279
CA
332BC3200X
Customized Equipment (DME)
—
—
Other
Enumeration date
07/31/2012
Last updated
11/15/2024
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