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Individual

DR. JOHN P. BENJAMIN JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
1432 PETERMAN DR, ALEXANDRIA, LA 71301-3432
(318) 442-9613
(318) 442-9902
Mailing address
1432 PETERMAN DR, ALEXANDRIA, LA 71301-3432
(318) 442-9613
(318) 442-9902

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3249
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1832499
LA
Enumeration date
03/01/2007
Last updated
07/08/2007
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