# GREGG S. BONAMICI DDS, PC

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

## Provider details

- **NPI number:** 1629797758
- **Authorized official:** GREGG STUART BONAMICI DDS (DENTIST)
- **Authorized official phone:** (313) 565-8544

## Contact information

- **Practice address:** 23601 FORD RD STE 2, DEARBORN, MI 48128-1259
- **Practice address phone:** (313) 565-8544
- **Mailing address:** 9780 HAWTHORNE GLEN DR, GROSSE ILE, MI 48138-1686
- **Mailing address phone:** (734) 552-9277

## Taxonomy

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

## Other

- **Enumeration date:** 08/23/2022
- **Last updated:** 08/23/2022