Individual
BENJAMIN ATLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
100 BREWSTER BLVD, CAMP LEJEUNE, NC 28547-2575
(760) 519-4801
Mailing address
34800 BOB WILSON DR, SAN DIEGO, CA 92134-5000
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DDS101670
CA
1223G0001X
General Practice Dentistry
Primary
12691
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
VAD0000
—
CA
Enumeration date
08/21/2017
Last updated
06/14/2022
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