Bennett, Mac Leon

Bennett, Mac Leon is an individual health care provider with primary practice located at 714 B South Madison , Madisonville TX 77864. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Bennett, Mac Leon can be contacted via phone (936) 348-5158.

Contact Information

Primary practice address
714 B South Madison Madisonville TX 77864
Phone: (936) 348-5158
Fax: (936) 348-5622
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 8253 Texas

Profile Details

NPI number 1407968803
LBN Legal business name Bennett, Mac Leon
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 31st, 2006
Last updated Jun 19th, 2008 - about 16 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 1407968803 NPPES
Texas Other G6025601 TEXAS CHIP
Texas MEDICAID 008028501 TEXAS CHIP
Texas Other 86D579 TEXAS CHIP

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