Individual
LAURA BODNAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4675 E STATE ROAD 44 STE 104, WILDWOOD, FL 34785-7461
(352) 418-3041
Mailing address
2218 CROWN VILLAGE RD APT 402, OCOEE, FL 34761-3748
(732) 877-7539
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
110894
CA
122300000X
Dentist
Primary
DN31613
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/13/2024
Last updated
07/02/2026
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