| Organization Name: | BENTON DENTAL P.C |
| NPI Number: | 1598159980 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KEVIN ARTHUR GUZE (OWNER) |
| Mailing Address: | 1445 Main Street East Wilton |
| State: | ME US |
| Postal Code: | 04234 |
| Phone Number: | 2076459522 |
| Fax Number: | 2076459516 |
| NPI Enumeration Date: | 03/24/2015 |
| NPI Last Update Date: | 03/24/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | DEN4351 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ME |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |