Individual
DR. JOSEPH DAVIN BONAVILLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
888 COOK RD, ORANGEBURG, SC 29118-2126
(803) 516-0777
(803) 516-0577
Mailing address
888 COOK RD, ORANGEBURG, SC 29118-2126
(803) 516-0777
(803) 516-0577
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
0401411675
VA
1223E0200X
Endodontics
3516
WV
1223E0200X
Endodontics
Primary
4305
SC
1223E0200X
Endodontics
50-051910
NY
1223E0200X
Endodontics
DN013507
GA
Other
Enumeration date
05/22/2007
Last updated
10/09/2007
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