Individual
DR. MARK RICHARD BENNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2441 21ST ST, FORT CAMPBELL, KY 42223-5582
(270) 798-8977
Mailing address
2441 21ST ST, FORT CAMPBELL, KY 42223-5582
(270) 798-8977
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
019.019810
IL
1223G0001X
General Practice Dentistry
16-0000997
VT
1223G0001X
General Practice Dentistry
53740
CA
1223G0001X
General Practice Dentistry
Primary
DE00007213
WA
1223G0001X
General Practice Dentistry
DEN.00007213
CO
Other
Enumeration date
01/18/2006
Last updated
07/21/2022
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