| Benjamin Wang, DDS | |
|
2050a 2nd St Se, Kirtland Afb, NM 87117-5522 | |
| (505) 846-3200 | |
| Not Available |
| Full Name | Benjamin Wang |
|---|---|
| Gender | Male |
| Speciality | Dentist |
| Location | 2050a 2nd St Se, Kirtland Afb, New Mexico |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679139877 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DD5691 (New Mexico) | Primary |
| 122300000X | Dentist | 35487 (Texas) | Secondary |
| Entity Name | Unm Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1831218627 PECOS PAC ID: 4981795267 Enrollment ID: O20070801000589 |
| Mailing Address | Practice Location Address |
|---|---|
| Benjamin Wang, DDS 1100 Wilford Hall Loop Bldg 4554, Jbsa Lackland, TX 78236-5638 Ph: (210) 292-0755 | Benjamin Wang, DDS 2050a 2nd St Se, Kirtland Afb, NM 87117-5522 Ph: (505) 846-3200 |
Dr. Lynn Michael Johnson, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 2050 2nd St Se, Kirtland Afb, NM 87117 Phone: 505-846-2466 | |
Brett Mason Harrell, Dentist Medicare: Not Enrolled in Medicare Practice Location: 2050a 2nd St Se, Kirtland Afb, NM 87117 Phone: 937-818-5346 | |
Satpal S Jutla, DMD Dentist Medicare: Not Enrolled in Medicare Practice Location: 2050a 2nd St Se, Kirtland Afb, NM 87117 Phone: 505-846-3200 | |
Ronald Nelson, Dentist Medicare: Not Enrolled in Medicare Practice Location: 2050a Second Street Se, Kirtland Afb, NM 87117 Phone: 505-846-2607 | |
Dr. John Keith Paul Iii, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 2050 A Second St. Se, 377 Mdg, Kirtland Afb, NM 87117 Phone: 505-846-3055 | |
Mariah Gordon, Dentist Medicare: Not Enrolled in Medicare Practice Location: 2050a 2nd St Se, Kirtland Afb, NM 87117 Phone: 505-846-3200 | |
Dr. Steven C. Fenzl, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 377 Dental Sq/sgd, 2050a 2nd St Se, Kirtland Afb, NM 87117 Phone: 505-846-2548 Fax: 505-846-2428 |