Individual
DR. GREGORY S BENSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
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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