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Organization

RAYMOND BONOMO PERIODONTICS

Active
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Organization

RAYMOND BONOMO PERIODONTICS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RAYMOND BONOMO D.M.D (OWNER)
(513) 671-0222
Entity
Organization

Contact information

Practice address
424 RAY NORRISH DR, CINCINNATI, OH 45246-1520
(513) 671-0222
(513) 671-0256
Mailing address
34 REMICK BLVD, SPRINGBORO, OH 45066-9168
(937) 886-9940
(937) 886-9945

Taxonomy

Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
021449
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1588715726
NPI #
OH
Enumeration date
03/13/2012
Last updated
03/13/2012
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