Individual
DR. MARK P BENNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
212 E BROAD ST, WINDER, GA 30680-2202
(770) 867-3275
(770) 586-5718
Mailing address
212 E BROAD ST, WINDER, GA 30680-2202
(770) 867-3275
(770) 586-5718
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
010081
GA
Other
Enumeration date
11/01/2006
Last updated
07/08/2007
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