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DR. MARIO BENAVENTE DDS
General Practice >> Dentist >> Dental ProvidersRegistrant NPI Number: 1225047327
Individual Registrant:DR. MARIO BENAVENTE DDS
Gender: M
Sole Proprietor
Gender: M
Sole Proprietor
Location and contact information for practice:
298 LINDEN AVE SAN BRUNO, CA 94066-4805 US
Tel: 650-589-0494 Fax: --
Tel: 650-589-0494 Fax: --
Contact information for business:
298 LINDEN AVE SAN BRUNO, CA 94066-4805 US
Tel: -- Fax: --
Tel: -- Fax: --
Registration Information:
NPI: 1225047327
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 1223G0001X | Dental Providers Dentist General Practice | CA | 35677 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
