# DRS BONIFANT & BROOKRESON DDS PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Briarwood Dental Center PLLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1356451405
- **Authorized official:** DR. WILLIAM W BONIFANT DDS (OFFICER)
- **Authorized official phone:** (304) 263-3367

## Contact information

- **Practice address:** 1003 SUSHRUTA DR, MARTINSBURG, WV 25401
- **Practice address phone:** (304) 263-3367
- **Practice address fax:** (304) 263-1634
- **Mailing address:** 1003 SUSHRUTA DR, MARTINSBURG, WV 25401
- **Mailing address phone:** (304) 263-3367
- **Mailing address fax:** (304) 263-1634

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 08/30/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 850292 | UNITED CONCORDIA | WV |