Individual
MRS. KACIE BENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1441 NE 10TH AVE, PAYETTE, ID 83661-5420
(208) 642-7364
(208) 642-4565
Mailing address
1441 NE 10TH AVE, PAYETTE, ID 83661-5420
(208) 642-7364
(208) 642-4565
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH-3120-EA
ID
124Q00000X
Dental Hygienist
H7514
OR
Other
Enumeration date
05/31/2017
Last updated
07/21/2022
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