| Lyle I Bonny | |
|
112 S 39th St Yakima WA 98901-1450 | |
| (509) 248-4957 | |
| (509) 575-5436 |
| Full Name | Lyle I Bonny |
|---|---|
| Speciality | Dentist |
| Location | 112 S 39th St, Yakima, Washington |
| Authorized Official Name and Position | Dee Horst (ACCOUNTS) |
| Authorized Official Contact | 5092484957 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lyle I Bonny 112 S 39th St Yakima WA 98901-1450 Ph: (509) 248-4957 | Lyle I Bonny 112 S 39th St Yakima WA 98901-1450 Ph: (509) 248-4957 |
| NPI Number | 1588112841 |
|---|---|
| Provider Enumeration Date | 09/15/2016 |
| Last Update Date | 09/15/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588112841 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 00006196 (Washington) | Primary |
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