Bonvallet Family Dentistry, Llc | |
727 Main St Pecatonica IL 61063-7740 | |
(815) 239-1313 | |
Not Available |
Full Name | Bonvallet Family Dentistry, Llc |
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Speciality | Dentist - General Practice |
Location | 727 Main St, Pecatonica, Illinois |
Authorized Official Name and Position | Anna M Bonvallet (OWNER) |
Authorized Official Contact | 8152391313 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Bonvallet Family Dentistry, Llc 727 Main St Po Box 608 Pecatonica IL 61063-7740 Ph: (815) 239-1313 | Bonvallet Family Dentistry, Llc 727 Main St Pecatonica IL 61063-7740 Ph: (815) 239-1313 |
NPI Number | 1306383872 |
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Provider Enumeration Date | 01/23/2017 |
Last Update Date | 01/23/2017 |
Identifier | Type | State | Issuer |
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1306383872 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223G0001X | Dentist - General Practice | 019016389 (Illinois) | Primary |