Individual
TRUDY MARIE BONVINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS MS
Contact information
Practice address
14065 COMMERCE AVE NE, PRIOR LAKE, MN 55372-1436
(952) 469-3333
Mailing address
14065 COMMERCE AVE NE, PRIOR LAKE, MN 55372-1436
(952) 469-3333
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
10859
MN
Other
Enumeration date
12/28/2006
Last updated
07/07/2014
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