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Individual

DR. JOSEPH RONALD BENNETT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.M.D.

Contact information

Practice address
1211 W WHEELER PKWY, AUGUSTA, GA 30909-1899
(706) 210-7061
(706) 210-7065
Mailing address
1211 W WHEELER PKWY, AUGUSTA, GA 30909-1899
(706) 210-7061
(706) 210-7065

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
10388
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
560008
UNITED CONCORDIA
GA
05
9181916
GA
Enumeration date
03/15/2007
Last updated
07/09/2007
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