Individual
DEAN R BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
13350 FRANKLIN FARM ROAD, SUITE 220, HERNDON, VA 20171
(703) 471-5300
(703) 471-4391
Mailing address
PO BOX 71230, PHILADELPHIA, PA 19176-6230
(703) 383-6424
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
0101036600
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200019375
MEDICARE RAILROAD
—
05
—
6402062
—
VA
Enumeration date
07/21/2006
Last updated
03/29/2011
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