Provider Demographics
NPI:1427330554
Name:BENSON, SAOLY X (DDS, MS)
Entity type:Individual
Prefix:
First Name:SAOLY
Middle Name:X
Last Name:BENSON
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1452 W HORIZON RIDGE PKWY # 653
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89012-4422
Mailing Address - Country:US
Mailing Address - Phone:253-985-3120
Mailing Address - Fax:
Practice Address - Street 1:5980 S DURANGO DR STE 124
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-1775
Practice Address - Country:US
Practice Address - Phone:702-800-4698
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-14
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV6177122300000X
NVS3-2721223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
No122300000XDental ProvidersDentist