Benton, Gail V

Benton, Gail V is an individual health care provider with primary practice located at 4463 N State St , Jackson MS 39206. She recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as her primary health care specialty. Benton, Gail V can be contacted via phone (601) 714-2908.

Contact Information

Primary practice address
4463 N State St Jackson MS 39206
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X 3521-09 Mississippi

Profile Details

NPI number 1497747661
LBN Legal business name Benton, Gail V
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 16th, 2005
Last updated Oct 10th, 2016 - about 9 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 1497747661 NPPES
Mississippi Other 3521-09 DENTAL LICENSE
Mississippi MEDICAID 9907750 DENTAL LICENSE
Mississippi MEDICAID 1846066 DENTAL LICENSE

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