Individual
KEITH BENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
145 DON PASQUAL RD NW, LOS LUNAS, NM 87031-8841
(505) 865-4618
Mailing address
145 DON PASQUAL RD NW, LOS LUNAS, NM 87031-8841
(505) 865-4618
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/23/2010
Last updated
02/04/2013
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