Individual
BRENNAN JOSEPH BENSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8942 S BROADWAY AVE # 128, TYLER, TX 75703-5443
(903) 405-1552
Mailing address
11006 WESTHAVEN CIR, FLINT, TX 75762-0317
(337) 352-1326
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
37246
TX
Other
Enumeration date
06/09/2021
Last updated
06/09/2021
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