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Individual
DR. FREDRIC L BONINE
Active
Individual
DR. FREDRIC L BONINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS, MS, PC
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
2910112106
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1184980914
SOLE PROPRIETOR NPI
MI
Enumeration date
06/30/2006
Last updated
05/22/2012
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