William P Bennett, DDS

Individual provider Active NPI General Practice Dentistry · Weston, WV

NPI 1811909427 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1811909427
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
2403 (WV)
Practice address
324 Center Ave
Weston, WV 26452-2031
Phone
(304) 269-3723
Fax
(304) 269-3723
NPI assigned
Aug 12, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2403WVMDMental Health Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2403 WV Yes

Addresses

Primary practice location

324 Center Ave
Weston, WV 26452-2031

Mailing address

324 Center Ave
Weston, WV 26452-2031
Phone (304) 269-3723

Other identifiers

IdentifierTypeStateIssuer
0134732000MedicaidWV

Other providers in Weston, WV

All providers in Weston, WV · General Practice Dentistry in West Virginia

Sources for this page

Verify at the official NPI Registry.