Individual
JACOB ANTHONY BONOLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
100 FORREST TER, MARSHALL, TX 75670-6804
(903) 938-8315
Mailing address
1800 BARRINGTON DR, KELLER, TX 76262-9004
(817) 915-0888
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
39027
TX
Other
Enumeration date
09/29/2022
Last updated
09/29/2022
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