Provider Demographics
NPI:1285771840
Name:BENSON, CARTER M (DDS)
Entity type:Individual
Prefix:DR
First Name:CARTER
Middle Name:M
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 1:13780 W GREENFIELD AVE
Mailing Address - Street 2:SUITE 780
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53005-7192
Mailing Address - Country:US
Mailing Address - Phone:262-782-4860
Mailing Address - Fax:262-782-7720
Practice Address - Street 1:13780 W GREENFIELD AVE
Practice Address - Street 2:SUITE 780
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53005-7192
Practice Address - Country:US
Practice Address - Phone:262-782-4860
Practice Address - Fax:262-782-7720
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI50301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice