Individual
DR. TIMOTHY A. BENICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
135 JOHNSON FERRY RD, STE 2100, MARIETTA, GA 30068-4942
(770) 953-3143
Mailing address
459 SHADOWLAWN RD SE, MARIETTA, GA 30067-4326
(770) 953-3143
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7987
GA
Other
Enumeration date
11/01/2006
Last updated
07/08/2007
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