Individual
DR. BEAU C. BENICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2220 BLACKWELL CHASE CT, MARIETTA, GA 30062-8505
(770) 971-4662
(770) 644-0045
Mailing address
2220 BLACKWELL CHASE PARK, MARIETTA, GA 30062
(770) 971-4662
(770) 644-0045
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
13103
GA
Other
Enumeration date
11/01/2006
Last updated
07/08/2007
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