| Doctor Name: | MRS. SUZANNE MP BENNETT |
| NPI Number: | 1881659936 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | DO |
| License Number: | 3258 |
| Business Practice Address: | 18275 N 59th Ave Bldg H Ste 144 Glendale, AZ - 853081253 |
| Business Phone Number: | 6028432300 |
| Business Fax Number: | 6028432310 |
| Mailing Address: | 18275 N 59th Ave, Bldg H Ste 144 GLENDALE |
| State: | AZ |
| Postal Code: | 85308 |
| Phone Number: | 6028432300 |
| Fax Number: | 6028432310 |
| NPI Enumeration Date: | 04/20/2006 |
| NPI Last Update Date: | 11/14/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 3258 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |