Individual
BENJAMIN IMMERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4030 PARK BLVD N, PINELLAS PARK, FL 33781-3633
(727) 341-5171
Mailing address
5033 WHISKEY HILL RD, WOLCOTT, NY 14590-9318
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
22DI02809900
NJ
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DN26544
FL
Other
Enumeration date
03/06/2013
Last updated
11/17/2021
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