Individual
DR. DAVID RICHARD BONANNO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
11717 BERNARDO PLAZA CT STE 100, SAN DIEGO, CA 92128-2419
(858) 673-1633
(858) 673-0093
Mailing address
11717 BERNARDO PLAZA CT STE 100, SAN DIEGO, CA 92128-2419
(858) 673-1633
(858) 673-0093
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DEN.00203979
CO
1223G0001X
General Practice Dentistry
DEN.00203979
CO
Other
Enumeration date
07/10/2019
Last updated
08/16/2024
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