Provider Demographics
NPI:1215317078
Name:HURD, BENJAMIN HENRY (DMD)
Entity type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:HENRY
Last Name:HURD
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:819 GRIFFIS ST
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-3709
Mailing Address - Country:US
Mailing Address - Phone:814-558-8591
Mailing Address - Fax:
Practice Address - Street 1:819 GRIFFIS ST
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-3709
Practice Address - Country:US
Practice Address - Phone:814-558-8591
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-05
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC100811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice