Individual
DR. JUSTIN DREW BONNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
3234 64TH ST STE B, LUBBOCK, TX 79413-5761
(806) 722-3637
(806) 722-3638
Mailing address
3234 64TH ST STE B, LUBBOCK, TX 79413-5761
(806) 722-3637
(806) 722-3638
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
62320
CA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
31701
TX
Other
Enumeration date
06/17/2014
Last updated
06/25/2024
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