Organization
LYLE I BONNY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEE HORST (ACCOUNTS)
(509) 248-4957
Entity
Organization
Contact information
Practice address
112 S 39TH ST, YAKIMA, WA 98901-1450
(509) 248-4957
(509) 575-5436
Mailing address
112 S 39TH ST, YAKIMA, WA 98901-1450
(509) 248-4957
(509) 575-5436
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
00006196
WA
Other
Enumeration date
09/15/2016
Last updated
09/15/2016
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