Individual
DR. VINCENT VERN BENIVEGNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
325 W LAKE LANSING RD, EAST LANSING, MI 48823-8524
(517) 337-9759
(517) 337-8156
Mailing address
325 W LAKE LANSING RD, EAST LANSING, MI 48823-8524
(517) 337-9759
(517) 337-8156
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
2901015585
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10-3360161
—
MI
Enumeration date
09/09/2005
Last updated
10/26/2011
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