Individual
GEORGE BENFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
702 MARTIN LUTHER KING ST, MOUND BAYOU, MS 38762-9314
(662) 741-2151
(662) 741-2339
Mailing address
702 MARTIN LUTHER KING ST, MOUND BAYOU, MS 38762-9314
(662) 741-2151
(662) 741-2339
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1961-82
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00660238
—
MS
Enumeration date
08/21/2007
Last updated
08/21/2007
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