Individual
BRIAN R BONCZEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
100 PRICEDALE RD, BELLE VERNON, PA 15012-1968
(724) 929-4939
Mailing address
PO BOX 3189, SYRACUSE, NY 13220-3189
(315) 454-6000
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS038406
PA
Other
Enumeration date
08/10/2010
Last updated
08/10/2010
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