Doctor Name: | DR. BENJAMIN IRZYK |
NPI Number: | 1588082002 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DMD |
License Number: | |
Business Practice Address: | 375 6th St Dover, NH - 038205935 |
Business Phone Number: | 6037490636 |
Business Fax Number: | |
Mailing Address: | 375 6th St, DOVER |
State: | NH |
Postal Code: | 038205935 |
Phone Number: | 6037490636 |
Fax Number: | |
NPI Enumeration Date: | 04/01/2014 |
NPI Last Update Date: | 07/02/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CT |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |