Individual
CHARLES ALFRED BENAVIDEZ SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
8007 LAGUNA BLVD STE 3, ELK GROVE, CA 95758-8127
(916) 683-3011
Mailing address
8007 LAGUNA BLVD STE 3, ELK GROVE, CA 95758-8127
(916) 683-3011
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
42805
CA
Other
Enumeration date
07/29/2019
Last updated
07/29/2019
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