Individual
DR. BENJAMIN J GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
500 N INDIANA AVE, WINSLOW, AZ 86047
(928) 289-6226
Mailing address
4255 E SOLIERE AVE APT 215, FLAGSTAFF, AZ 86004-7930
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D008660
AZ
Other
Enumeration date
06/12/2013
Last updated
06/12/2013
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