| Sandra J. Bennett, DMD LLC | |
|
22400 Se Stark St Gresham OR 97030-2656 | |
| (503) 667-0438 | |
| (503) 665-4870 |
| Full Name | Sandra J. Bennett, DMD LLC |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 22400 Se Stark St, Gresham, Oregon |
| Authorized Official Name and Position | Sandra J. Bennett (OWNER) |
| Authorized Official Contact | 5036670438 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sandra J. Bennett, DMD LLC 22400 Se Stark St Gresham OR 97030-2656 Ph: (503) 667-0438 | Sandra J. Bennett, DMD LLC 22400 Se Stark St Gresham OR 97030-2656 Ph: (503) 667-0438 |
| NPI Number | 1053586529 |
|---|---|
| Provider Enumeration Date | 04/25/2008 |
| Last Update Date | 04/25/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053586529 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | () | Primary |
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