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Individual

ELISE M BONCHER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
550 CHERRY ST SE, CHERRY STREET HEALTH SERVICES - DENTAL, GRAND RAPIDS, MI 49503-4748
(616) 235-7289
Mailing address
550 CHERRY ST SE, CHERRY STREET HEALTH SERVICES - DENTAL, GRAND RAPIDS, MI 49503-4748
(616) 235-7289

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901019968
MI
1223G0001X
General Practice Dentistry
4539
SC

Other

Enumeration date
10/28/2008
Last updated
06/08/2009
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