Individual
DR. FRED BENZENHAFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
4045 TYRONE BLVD N, ST PETERSBURG, FL 33709-4118
(727) 547-3491
Mailing address
4045 TYRONE BLVD N, ST PETERSBURG, FL 33709-4118
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN21907
FL
1223G0001X
General Practice Dentistry
DN21907
FL
Other
Enumeration date
06/14/2016
Last updated
06/14/2016
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