| Benham Orthodontics | |
|
4060 Legacy Dr Ste 303 Frisco TX 75034-6658 | |
| (214) 618-8182 | |
| (214) 618-8184 |
| Full Name | Benham Orthodontics |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 4060 Legacy Dr Ste 303, Frisco, Texas |
| Authorized Official Name and Position | Jeremy Lustig (OWNER) |
| Authorized Official Contact | 8173506500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Benham Orthodontics 4060 Legacy Dr Ste 303 Frisco TX 75034-6658 Ph: (214) 618-8182 | Benham Orthodontics 4060 Legacy Dr Ste 303 Frisco TX 75034-6658 Ph: (214) 618-8182 |
| NPI Number | 1811165715 |
|---|---|
| Provider Enumeration Date | 02/13/2008 |
| Last Update Date | 03/07/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811165715 | NPI | - | NPPES |
| 197672201 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (* (Not Available)) | Primary |
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Secondary |
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