Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | DS027633L | PA |
NPI | 1073786919 |
---|---|
Provider Name | Robert M Bentz |
First Address | East Norriton, PA 19401-1818 |
Second Address | East Norriton, PA 19401-1818 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2008 |
Last Update Date | 11/04/2008 |