Organization
BOHANNAN DENTAL CORPORATION
Active
Other names
William B. Bohannan DDS, MD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM B BOHANNAN D.D.S., M.D. (OWNER PRESIDENT)
(408) 286-1553
Entity
Organization
Contact information
Practice address
2025 FOREST AVE, SUITE 6, SAN JOSE, CA 95128-4806
(408) 286-1553
(408) 286-8511
Mailing address
2025 FOREST AVE, SUITE 6, SAN JOSE, CA 95128-4806
(408) 286-1553
(408) 286-8511
Taxonomy
Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
A66471
CA
Other
Enumeration date
12/12/2006
Last updated
08/22/2020
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