Individual
BONOLO BLESSED ODIRILE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
B.D.S
Contact information
Practice address
2101 MIDLAND DRIVE, #14, MIDLAND, TX 79701
(423) 699-6222
Mailing address
5813 ALBRIGHT CT, EAU CLAIRE, WI 54701-5045
(267) 270-0068
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
0401415448
VA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
32617
TX
Other
Enumeration date
02/06/2017
Last updated
02/06/2017
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