Bennett, Jeffrey David

Bennett, Jeffrey David is an individual health care provider with primary practice located at 1050 Wishard Blvd Room 4201, Indianapolis IN 46202-2872. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Bennett, Jeffrey David can be contacted via phone (317) 278-3699.

Contact Information

Primary practice address
1050 Wishard Blvd Room 4201 Indianapolis IN 46202-2872
Phone: (317) 278-3699
Fax: (317) 278-2243
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 12010608A Indiana

Profile Details

NPI number 1053416602
LBN Legal business name Bennett, Jeffrey David
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 14th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053416602 NPPES
Indiana MEDICAID 200461850A

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