Provider Demographics
NPI:1609191352
Name:BENTON, BRANDON KYLE (DDS)
Entity type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:KYLE
Last Name:BENTON
Suffix:
Gender:
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 N 34TH ST
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72756-0352
Mailing Address - Country:US
Mailing Address - Phone:479-265-1400
Mailing Address - Fax:479-265-1400
Practice Address - Street 1:201 N 34TH ST
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72756-0352
Practice Address - Country:US
Practice Address - Phone:792-651-4004
Practice Address - Fax:479-265-1400
Is Sole Proprietor?:No
Enumeration Date:2010-04-06
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR37161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice