Individual
DR. BENJAMIN JAMES PERRAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1203 N WILCOX DR, KINGSPORT, TN 37660-4971
(423) 247-5175
Mailing address
1203 N WILCOX DR, KINGSPORT, TN 37660-4971
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12638
TN
1223G0001X
General Practice Dentistry
DEN.00205337
CO
Other
Enumeration date
08/25/2022
Last updated
01/31/2025
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