Organization
BRYAN E BONNET DDS PC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRYAN E BONNET DDS (OWNER/DENTIST)
(918) 322-6445
Entity
Organization
Contact information
Practice address
12195 S YUKON AVE, GLENPOOL, OK 74033-6621
(918) 322-9445
Mailing address
12195 S YUKON AVE, GLENPOOL, OK 74033-6621
(918) 322-9445
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100255520A
—
OK
Enumeration date
10/19/2022
Last updated
10/19/2022
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