Individual
DR. JONATHAN SIMON BENSOUSSAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3443 N CENTRAL AVE STE 700, PHOENIX, AZ 85012-2208
(602) 242-2256
Mailing address
3443 N CENTRAL AVE STE 700, PHOENIX, AZ 85012-2208
(602) 242-2256
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
010920
AZ
Other
Enumeration date
01/12/2018
Last updated
05/24/2021
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