Benton Family Dentistry LLC

Organization Active NPI General Practice Dentistry · Benton, LA

NPI 1821319476 · NPPES record last updated Jun 17, 2010

Key facts

NPI
1821319476
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Dentistry 1223G0001X
License
5793 (LA)
Legal business name
BENTON FAMILY DENTISTRY LLC
Practice address
192 Burt Blvd
Benton, LA 71006-4900
Phone
(318) 965-2424
Fax
(318) 965-0943
NPI assigned
Jun 17, 2010
Organization subpart
No

Authorized official

Name
Dr. Misty Crump, D.D.S.
Title
Dentist
Phone
(318) 965-2424

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

192 Burt Blvd
Benton, LA 71006
Phone (318) 965-2424

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry
Group: 193400000X SINGLE SPECIALTY GROUP
1223G0001X 5793 LA Yes

Addresses

Primary practice location

192 Burt Blvd
Benton, LA 71006-4900

Mailing address

PO Box 427
Benton, LA 71006-0427
Phone (318) 965-2424

Other providers in Benton, LA

All providers in Benton, LA · General Practice Dentistry in Louisiana

Sources for this page

Verify at the official NPI Registry.