York, Bennett Van

York, Bennett Van is an individual health care provider with primary practice located at 1421 S 28Th Ave , Hattiesburg MS 39402-3108. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. York, Bennett Van can be contacted via phone (601) 264-7611.

Contact Information

Primary practice address
1421 S 28Th Ave Hattiesburg MS 39402-3108
Phone: (601) 264-7611
Fax: (601) 268-0693
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X OS1679 Tennessee

Profile Details

NPI number 1417045386
LBN Legal business name York, Bennett Van
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 10th, 2006
Last updated Oct 18th, 2023 - about last year

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 1417045386 NPPES
Mississippi MEDICAID 0660133
Mississippi Other 1182-65

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