Provider Demographics
NPI:1861046377
Name:NANNETTE BENEDICT DDS ASSOCIATES
Entity type:Organization
Organization Name:NANNETTE BENEDICT DDS ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:RITA
Authorized Official - Last Name:RIPPE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:831-440-9214
Mailing Address - Street 1:5015 SCOTTS VALLEY DRIVE
Mailing Address - Street 2:
Mailing Address - City:SCOTTS VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95066
Mailing Address - Country:US
Mailing Address - Phone:831-440-9214
Mailing Address - Fax:831-438-6412
Practice Address - Street 1:5015 SCOTTS VALLEY DRIVE
Practice Address - Street 2:
Practice Address - City:SCOTTS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95066
Practice Address - Country:US
Practice Address - Phone:831-440-9214
Practice Address - Fax:831-438-6412
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-01
Last Update Date:2019-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty