Individual
DR. JUSTIN KEITH BONAVENTURE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
13702 COURSEY BLVD. BLDG 10, STE C, BATON ROUGE, LA 70817
(225) 925-2118
Mailing address
13702 COURSEY BLVD. BLDG 10, STE C, BATON ROUGE, LA 70817
(225) 925-2118
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5958
LA
Other
Enumeration date
01/06/2010
Last updated
04/28/2020
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