| Dr Tracy C Benton Dds Apdc | |
|
1310 South Range Ave Denham Springs LA 70726 | |
| (225) 664-0040 | |
| Not Available |
| Full Name | Dr Tracy C Benton Dds Apdc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1310 South Range Ave, Denham Springs, Louisiana |
| Authorized Official Name and Position | Tracy Clark Benton (PRESIDENT) |
| Authorized Official Contact | 2256640040 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Tracy C Benton Dds Apdc Po Box 952 Denham Springs LA 70727-0952 Ph: (225) 664-0040 | Dr Tracy C Benton Dds Apdc 1310 South Range Ave Denham Springs LA 70726 Ph: (225) 664-0040 |
| NPI Number | 1366581886 |
|---|---|
| Provider Enumeration Date | 02/05/2007 |
| Last Update Date | 02/25/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366581886 | NPI | - | NPPES |
| 1830577 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 3057 (Louisiana) | Primary |
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