Individual
DR. C RICHARD BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS, PHD
Contact information
Practice address
15 FOREST GLEN DR, PITTSBURGH, PA 15228-1512
(412) 343-6798
Mailing address
15 FOREST GLEN DR, PITTSBURGH, PA 15228-1512
(412) 343-6798
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS015320L
PA
122300000X
Dentist
DS015320LA
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0017262150001
—
PA
Enumeration date
09/27/2006
Last updated
07/08/2007
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