Benton, Tracy C.

Benton, Tracy C. is an individual health care provider with primary practice located at 1310 S Range Ave , Denham Springs LA 70726-4810. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Benton, Tracy C. can be contacted via phone (225) 664-0040.

Contact Information

Primary practice address
1310 S Range Ave Denham Springs LA 70726-4810
Phone: (225) 664-0040
Fax: (225) 664-0042
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 3057 Louisiana

Profile Details

NPI number 1487079208
LBN Legal business name Benton, Tracy C.
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 3rd, 2014
Last updated Mar 3rd, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487079208 NPPES
Louisiana MEDICAID 1830577

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