Individual
DR. CHARLES J. BENCIVENGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
21 PLEASANT ST, BRISTOL, CT 06010-6254
(860) 582-8095
(860) 589-3615
Mailing address
21 PLEASANT ST, BRISTOL, CT 06010-6254
(860) 582-8095
(860) 589-3615
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4945
CT
Other
Enumeration date
09/28/2006
Last updated
07/08/2007
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