Individual
DR. STEPHEN MICHAEL BENJAMIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D., M.S.
Contact information
Practice address
3306 W CHARTWELL RD, PEORIA, IL 61614-2322
(309) 690-0011
Mailing address
3306 W CHARTWELL RD, PEORIA, IL 61614-2322
(309) 690-0011
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
IL
1223E0200X
Endodontics
Primary
—
IL
Other
Enumeration date
11/11/2006
Last updated
08/31/2007
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