Individual
ANDREW O BONAVITA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
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
1223G0001X
General Practice Dentistry
Primary
17903
MA
Other
Enumeration date
08/20/2006
Last updated
07/08/2007
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