Provider Demographics
NPI:1366559965
Name:HALTON, BENJAMIN T (DMD)
Entity type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:T
Last Name:HALTON
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 1:1515 MONTROSE ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19146-2114
Mailing Address - Country:US
Mailing Address - Phone:215-219-5482
Mailing Address - Fax:
Practice Address - Street 1:MAIN & OVERBROOK RD
Practice Address - Street 2:
Practice Address - City:HATFIELD
Practice Address - State:PA
Practice Address - Zip Code:19440-0460
Practice Address - Country:US
Practice Address - Phone:215-368-7025
Practice Address - Fax:215-368-7026
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0359791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice