Individual
DR. CHRISTOPHER E BONACCI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.D.
Contact information
Practice address
361 MAPLE AVE W, VIENNA, VA 22180-4304
(703) 255-9400
(703) 255-4958
Mailing address
361 MAPLE AVENUE W., VIENNA, VA 22180
(703) 255-9400
(703) 255-4958
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
0401102631
VA
Other
Enumeration date
05/08/2013
Last updated
05/08/2013
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