# BONNESS FAMILY DENTISTRY PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1245491471
- **Authorized official:** RICHARD AARON BONNESS D.D.S. (PRESIDENT)
- **Authorized official phone:** (317) 821-1130

## Contact information

- **Practice address:** 10701 ALLIANCE DR, SUITE F, CAMBY, IN 46113-8836
- **Practice address phone:** (317) 821-1130
- **Practice address fax:** (317) 821-1145
- **Mailing address:** 10701 ALLIANCE DR, SUITE F, CAMBY, IN 46113-8836
- **Mailing address phone:** (317) 821-1130
- **Mailing address fax:** (317) 821-1145

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 12010300A | IN | Yes |

## Other

- **Enumeration date:** 06/20/2008
- **Last updated:** 06/20/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 200453220 | — | IN |