Individual
DR. GREGORY S BENSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
8809 W 400 N, MICHIGAN CITY, IN 46360-9330
(219) 879-8710
(219) 879-8715
Mailing address
8809 W 400 N, MICHIGAN CITY, IN 46360-9330
(219) 879-8710
(219) 879-8715
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
12011706A
IN
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
5803
WI
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
36731
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33791200
—
WI
Enumeration date
09/22/2006
Last updated
09/28/2011
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