Individual
DR. CHARLES BENLEY LENNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
15613 GENERAL PULLER HWY, DELTAVILLE, VA 23043-2032
(804) 776-9484
(804) 776-7487
Mailing address
PO BOX 736, DELTAVILLE, VA 23043-0736
(804) 776-9484
(804) 776-7487
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7109
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051994
ANTHEM BC BS
VA
01
—
8439
UNITED CONCORDIA
VA
Enumeration date
08/16/2006
Last updated
07/08/2007
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