Longhorn Ranch Oral And Maxillofacial Surgery Pc | |
3610 Capital Ave Sw Battle Creek MI 49015-9354 | |
(269) 965-1339 | |
Not Available |
Full Name | Longhorn Ranch Oral And Maxillofacial Surgery Pc |
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Speciality | Dentist |
Location | 3610 Capital Ave Sw, Battle Creek, Michigan |
Authorized Official Name and Position | Jonathan Bonnet (PRESIDENT) |
Authorized Official Contact | 2142263980 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Longhorn Ranch Oral And Maxillofacial Surgery Pc 3610 Capital Ave Sw Battle Creek MI 49015-9354 Ph: (269) 965-1339 | Longhorn Ranch Oral And Maxillofacial Surgery Pc 3610 Capital Ave Sw Battle Creek MI 49015-9354 Ph: (269) 965-1339 |
NPI Number | 1831546407 |
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Provider Enumeration Date | 05/24/2016 |
Last Update Date | 10/14/2016 |
Medicare PECOS PAC ID | 2466730783 |
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Medicare Enrollment ID | O20161020001354 |
Identifier | Type | State | Issuer |
---|---|---|---|
1831546407 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223S0112X | Dentist - Oral And Maxillofacial Surgery | 2901020237 (Michigan) | Primary |
Provider Name | Jonathan C Bonnet |
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Provider Type | Practitioner - Oral Surgery |
Provider Identifiers | NPI Number: 1447679444 PECOS PAC ID: 5799087102 Enrollment ID: I20161025002099 |
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