Provider Demographics
NPI:1801071774
Name:BENCIC, ROBERT JOSEPH (DDS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:JOSEPH
Last Name:BENCIC
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 1:412 CAPTAINS CV
Mailing Address - Street 2:UNIT E
Mailing Address - City:EDENTON
Mailing Address - State:NC
Mailing Address - Zip Code:27932-8862
Mailing Address - Country:US
Mailing Address - Phone:850-228-8888
Mailing Address - Fax:
Practice Address - Street 1:100 HEALTH CENTER DR
Practice Address - Street 2:
Practice Address - City:AHOSKIE
Practice Address - State:NC
Practice Address - Zip Code:27910-8161
Practice Address - Country:US
Practice Address - Phone:252-737-7200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-09
Last Update Date:2015-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY355291223G0001X
NC96841223G0001X
FLHAD521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice