Provider Demographics
NPI:1154525467
Name:BENSON, MELVIN B (DDS)
Entity type:Individual
Prefix:DR
First Name:MELVIN
Middle Name:B
Last Name:BENSON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10914 HEFNER POINTE DR STE 150
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-5068
Mailing Address - Country:US
Mailing Address - Phone:405-946-5558
Mailing Address - Fax:405-946-5584
Practice Address - Street 1:10914 HEFNER POINTE DR STE 150
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-5068
Practice Address - Country:US
Practice Address - Phone:405-946-5558
Practice Address - Fax:405-946-5584
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-12
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS60370122300000X
OK5987122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist