# BONNER ORAL SURGERY, PLLC

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

## Provider details

- **NPI number:** 1578236527
- **Authorized official:** DR. JUSTIN BONNER DDS (MANAGING MEMBER)
- **Authorized official phone:** (325) 437-3100

## Contact information

- **Practice address:** 4 HOSPITAL DR, ABILENE, TX 79606-5289
- **Practice address phone:** (325) 437-3100
- **Practice address fax:** (325) 437-3199
- **Mailing address:** 4 HOSPITAL DR, ABILENE, TX 79606-5289
- **Mailing address phone:** (325) 437-3100
- **Mailing address fax:** (325) 437-3199

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 07/27/2021
- **Last updated:** 07/27/2021