Individual
DR. TANNER DOUGLAS BENNION
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2700 GRAND AVE STE B, BILLINGS, MT 59102-2682
(801) 368-9811
Mailing address
6238 SW 85TH ST, GAINESVILLE, FL 32608-8512
(801) 368-9811
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DEN-DEN-LIC-5951
MT
Other
Enumeration date
02/12/2015
Last updated
02/12/2015
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