Individual
MARY T BENJAMIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
15 S CLAYTON ST, LAWRENCEVILLE, GA 30045-5715
(770) 339-4283
(770) 279-5983
Mailing address
PO BOX 897, 2570 RIVERSIDE PARKWAY, LAWRENCEVILLE, GA 30046-0897
(770) 339-4260
(770) 963-6322
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
DN010144
GA
Other
Enumeration date
05/01/2006
Last updated
07/08/2007
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