Provider Demographics
NPI:1306951488
Name:FRANK J BENENATI, DDS
Entity type:Organization
Organization Name:FRANK J BENENATI, DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:BENENATI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-863-3124
Mailing Address - Street 1:50 JOHN STARK HIGHWAY
Mailing Address - Street 2:SUGAR RIVER PLAZA
Mailing Address - City:NEWPORT
Mailing Address - State:NH
Mailing Address - Zip Code:03773
Mailing Address - Country:US
Mailing Address - Phone:603-863-3124
Mailing Address - Fax:603-863-6088
Practice Address - Street 1:50 JOHN STARK HIGHWAY
Practice Address - Street 2:SUGAR RIVER PLAZA
Practice Address - City:NEWPORT
Practice Address - State:NH
Practice Address - Zip Code:03773
Practice Address - Country:US
Practice Address - Phone:603-863-3124
Practice Address - Fax:603-863-6088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-20
Last Update Date:2015-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2663122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30302764Medicaid