Individual
DR. CYNTHIA LEAH BONAFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
907 GASTON AVE, FAIRMONT, WV 26554
(304) 363-2008
(304) 363-2109
Mailing address
907 GASTON AVE, FAIRMONT, WV 26554
(304) 363-2008
(304) 363-2109
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
3060
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0137742000
—
WV
Enumeration date
01/02/2007
Last updated
07/08/2007
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