# BONNIE J. ANDERSON

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

## Provider details

- **NPI number:** 1417365529
- **Authorized official:** DR. BONNIE ANDERSON DENTIST (OWNER)
- **Authorized official phone:** (701) 523-5651

## Contact information

- **Practice address:** 20 1ST AVE SW, BOX E, BOWMAN, ND 58623-4213
- **Practice address phone:** (701) 523-5651
- **Mailing address:** 20 1ST AVE NW, BOX E, BOWMAN, ND 58623
- **Mailing address phone:** (701) 523-5651
- **Mailing address fax:** (701) 523-5652

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 1771 | ND | Yes |

## Other

- **Enumeration date:** 08/01/2014
- **Last updated:** 08/01/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 41045 | — | ND |