Individual
STEPHEN D BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6363 FRANCE AVE S, #500, EDINA, MN 55435
(952) 920-7660
(952) 920-2049
Mailing address
6363 FRANCE AVE S, #500, EDINA, MN 55435
(952) 920-7660
(952) 920-2049
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
104548
MN
208800000X
Urology Physician
6027031-1205
UT
Other
Enumeration date
05/26/2008
Last updated
08/24/2009
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