Individual
DR. CHRISTIAN MICHAEL BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
201 W MAIN ST, VINE GROVE, KY 40175-1304
(270) 877-2011
(270) 877-8553
Mailing address
822 N ELM ST, HENDERSON, KY 42420-2709
(270) 826-8899
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
10516
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/25/2020
Last updated
09/01/2020
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