Individual
DR. CHARLES MICHAEL BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
812 S STATE ST, OREM, UT 84097-7026
(801) 691-0457
(801) 691-1232
Mailing address
812 S STATE ST, OREM, UT 84097-7026
(801) 360-0981
(801) 691-1232
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
375815
UT
Other
Enumeration date
12/06/2006
Last updated
06/03/2016
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