Organization
BONNER ORTHODONTICS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA BONNER DDS, MS (MEMBER)
(479) 899-6400
Entity
Organization
Contact information
Practice address
402 S METRO PKWY, ROGERS, AR 72758-8530
(479) 899-6400
Mailing address
402 S METRO PKWY, ROGERS, AR 72758-8530
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
4016
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
209912631
—
AR
Enumeration date
12/30/2015
Last updated
12/30/2015
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