Individual
MICHAEL ISAAC BENICHOU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
621 S NEW BALLAS RD STE 16A, SAINT LOUIS, MO 63141-8239
(314) 251-6725
Mailing address
2000 LINWOOD AVE APT 23V, FORT LEE, NJ 07024-3015
(201) 783-9538
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
2024047430
MO
Other
Enumeration date
02/27/2020
Last updated
09/10/2025
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