Individual
DR. DANIEL DAVID BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
55701
WI
207ND0900X
Dermatopathology Physician
55701
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1655383-03
—
TX
Enumeration date
03/23/2006
Last updated
01/05/2021
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