Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 7665 | CO |
NPI | 1003936147 |
---|---|
Provider Name | Dr. David Stuart Bennett |
First Address | Arvada, CO 80007-7401 |
Second Address | Arvada, CO 80007-7401 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2007 |
Last Update Date | 08/07/2007 |