Organization
BENTON FAMILY DENTISTRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MISTY CRUMP D.D.S. (DENTIST)
(318) 965-2424
Entity
Organization
Contact information
Practice address
192 BURT BLVD, BENTON, LA 71006-4900
(318) 965-2424
(318) 965-0943
Mailing address
PO BOX 427, BENTON, LA 71006-0427
(318) 965-2424
(318) 965-0943
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5793
LA
Other
Enumeration date
06/17/2010
Last updated
06/17/2010
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