Benson, Gregory S

Benson, Gregory S is an sole proprietor health care provider with primary practice located at 8809 W 400 N , Michigan City IN 46360-9330. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery, Dental Providers / Oral and Maxillofacial Surgery. Dental Providers / Oral and Maxillofacial Surgery is his primary health care specialty. Benson, Gregory S can be contacted via phone (219) 879-8710.

Contact Information

Primary practice address
8809 W 400 N Michigan City IN 46360-9330
Phone: (219) 879-8710
Fax: (219) 879-8715
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery 204E00000X 36731 Wisconsin
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 5803 Wisconsin
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 12011706A Indiana

Profile Details

NPI number 1982704847
LBN Legal business name Benson, Gregory S
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 22nd, 2006
Last updated Sep 28th, 2011 - about 13 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 1982704847 NPPES
Wisconsin MEDICAID 33791200

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