Provider Demographics
NPI:1144636416
Name:BENITEZ, CHRISTIAN DANIEL (DMD)
Entity type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:DANIEL
Last Name:BENITEZ
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:480 MAPLEWOOD DR STE 4
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-5845
Mailing Address - Country:US
Mailing Address - Phone:561-626-9400
Mailing Address - Fax:561-744-1047
Practice Address - Street 1:480 MAPLEWOOD DR STE 4
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458
Practice Address - Country:US
Practice Address - Phone:561-626-9400
Practice Address - Fax:561-744-0147
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-08
Last Update Date:2018-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN229351223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics