Individual
DR. JOHN R BOMMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
442 W HIGH ST, SUITE 2, BRYAN, OH 43506-1681
(419) 636-3163
(419) 636-5037
Mailing address
442 W HIGH ST, SUITE 2, BRYAN, OH 43506-1681
(419) 636-3163
(419) 636-5037
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
30014512
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0278097
—
OH
01
—
30014512
JOHN BOMMER-DELTA DENTAL
OH
01
—
402257
UCCI - JOHN BOMMER
OH
Enumeration date
09/29/2006
Last updated
04/30/2010
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