Individual
DIEGO BONILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
5202 TEXANA DR APT 536, SAN ANTONIO, TX 78249-3793
(817) 937-1411
Mailing address
5202 TEXANA DR APT 536, SAN ANTONIO, TX 78249-3793
(817) 937-1411
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
30022
TX
Other
Enumeration date
06/18/2014
Last updated
06/18/2014
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