| NPI | 1679550602 |
|---|---|
| Professional Name | ANDY BENNION |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: OR D7367) |
| Additional Taxonomies | 122300000X Dentist (Licence: OR D7367) |
| 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment | |
| Enumeration Date | 2005-12-30 |
| Last Update Date | 2012-05-17 |