Individual
DR. MARVIN HAMILTON BOHNENKAMP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
4 EAGLE CT, FARMINGTON, MO 63640-7660
(573) 701-4433
Mailing address
4 EAGLE CT, FARMINGTON, MO 63640-7660
(573) 701-4433
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
012274
MO
Other
Enumeration date
10/21/2009
Last updated
10/21/2009
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