Provider Demographics
NPI:1447493309
Name:FOLEY, BENJAMIN DANIEL (DDS)
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:DANIEL
Last Name:FOLEY
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 1:1420 28TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80303-1081
Mailing Address - Country:US
Mailing Address - Phone:303-444-2255
Mailing Address - Fax:720-565-1091
Practice Address - Street 1:1420 28TH ST STE 100
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-1081
Practice Address - Country:US
Practice Address - Phone:303-444-2255
Practice Address - Fax:720-565-1091
Is Sole Proprietor?:No
Enumeration Date:2009-04-08
Last Update Date:2018-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.002019121223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery