Individual
DR. ALYSIA MARIE BONVINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
2509 RT 11, MAHER BUILDING, LAFAYETTE, NY 13084-9739
(315) 677-3113
(315) 677-3114
Mailing address
PO BOX 259, LAFAYETTE, NY 13084
(315) 677-3113
(315) 677-3114
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
048093
NY
Other
Enumeration date
11/05/2009
Last updated
11/05/2009
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