Provider Demographics
NPI:1386138188
Name:BENBOW, ANDREW (DDS, MDS)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:BENBOW
Suffix:
Gender:M
Credentials:DDS, MDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 E BLACKSTOCK RD STE D
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29301-2652
Mailing Address - Country:US
Mailing Address - Phone:903-278-4100
Mailing Address - Fax:
Practice Address - Street 1:233 E BLACKSTOCK RD STE D
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29301-2652
Practice Address - Country:US
Practice Address - Phone:864-576-3678
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-15
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC108781223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Multi-Specialty