Provider Demographics
NPI:1992964647
Name:RUTHERFORD, BENJAMIN P (DDS)
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:P
Last Name:RUTHERFORD
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 1:1605 SE 29TH ST
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66605-2601
Mailing Address - Country:US
Mailing Address - Phone:785-266-9100
Mailing Address - Fax:785-266-7717
Practice Address - Street 1:1605 SE 29TH ST
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66605-2601
Practice Address - Country:US
Practice Address - Phone:785-266-9100
Practice Address - Fax:785-266-7717
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-07
Last Update Date:2008-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS60560122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist