Individual
DR. BENJAMIN BANNEKER SHIRLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
16819 HILLSIDE AVE, JAMAICA, NY 11432-4340
(718) 291-1420
Mailing address
16819 HILLSIDE AVE, JAMAICA, NY 11432-4340
(718) 206-1420
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
054338
NY
Other
Enumeration date
06/01/2009
Last updated
06/01/2009
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