Individual
KEVIN BENJUMEA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
760 BROADWAY, BROOKLYN, NY 11206-5317
(646) 249-4121
Mailing address
8819 242ND ST, BELLEROSE, NY 11426-1240
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
062485
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/12/2020
Last updated
05/04/2023
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