Organization
ANDREW BONAVITA DMDPC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW O BONAVITA DMD (PRESIDENT)
(413) 567-7735
Entity
Organization
Contact information
Practice address
123 DWIGHT RD, LONGMEADOW, MA 01106-1748
(413) 567-7735
(413) 565-2579
Mailing address
123 DWIGHT RD, LONGMEADOW, MA 01106-1748
(413) 567-7735
(413) 565-2579
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
17903
MA
Other
Enumeration date
05/21/2008
Last updated
05/21/2008
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