Individual
DR. WILLIAM THADDEUS BENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
716 STEVENS AVE, PORTLAND, ME 04103
(978) 372-9122
(978) 372-6131
Mailing address
716 STEVENS AVE, PORTLAND, ME 04103-2656
(207) 221-4747
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
15695
MA
122300000X
Dentist
Primary
DEN4602
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
X05793
BLUE CROSS BLUE SHIELD OF
—
Enumeration date
10/25/2005
Last updated
09/04/2018
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