| Doctor Name: | KENNETH J BENTSON |
| NPI Number: | 1710961156 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | P.A. |
| License Number: | 9954 |
| Business Practice Address: | 1575 Lookout Dr North Mankato, MN - 560032503 |
| Business Phone Number: | 5076251811 |
| Business Fax Number: | |
| Mailing Address: | 1230 E Main St, Po Box 8674 MANKATO |
| State: | MN |
| Postal Code: | 560015066 |
| Phone Number: | 5076251811 |
| Fax Number: | |
| NPI Enumeration Date: | 11/30/2005 |
| NPI Last Update Date: | 01/13/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AS0400X |
| License Number: | 9954 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Surgical |
| Taxonomy Definition: | |