Sandra J. Bennett, Dmd LLC

NPI #1053586529 in Gresham, Oregon

Provider Information

NPI Number: 1053586529
Entity Type: Organization
Organization Name: Sandra J. Bennett, Dmd LLC
Primary Specialty: Clinic/Center - Dental
Enumeration Date: Apr 25, 2008
Last Updated: Apr 25, 2008

Practice Location

Address: 22400 SE STARK ST
City: Gresham
State: Oregon
ZIP Code: 97030-2656
Phone: (503) 667-0438

Authorized Official

Name: DR. SANDRA J. BENNETT, DMD
Title: OWNER
Phone: (503) 667-0438

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Dental — Dental	261QD0000X	Primary

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