| Bryan E Bonnet Dds Pc Inc | |
|
12195 S Yukon Ave Glenpool OK 74033-6621 | |
| (918) 322-9445 | |
| Not Available |
| Full Name | Bryan E Bonnet Dds Pc Inc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 12195 S Yukon Ave, Glenpool, Oklahoma |
| Authorized Official Name and Position | Bryan E Bonnet (OWNER/DENTIST) |
| Authorized Official Contact | 9183226445 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bryan E Bonnet Dds Pc Inc 12195 S Yukon Ave Glenpool OK 74033-6621 Ph: (918) 322-9445 | Bryan E Bonnet Dds Pc Inc 12195 S Yukon Ave Glenpool OK 74033-6621 Ph: (918) 322-9445 |
| NPI Number | 1356067474 |
|---|---|
| Provider Enumeration Date | 10/19/2022 |
| Last Update Date | 10/19/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356067474 | NPI | - | NPPES |
| 100255520A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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