Individual
DR. RICHARD MICHAEL BENNINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
5002 FOOTE RD, MEDINA, OH 44256-5396
(330) 725-8449
(330) 722-1805
Mailing address
5002 FOOTE RD, MEDINA, OH 44256-5396
(330) 725-8449
(330) 722-1805
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
301847
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9251381
MEDICARE PTAN
OH
Enumeration date
11/02/2006
Last updated
11/05/2020
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