Organization
LONGHORN RANCH ORAL AND MAXILLOFACIAL SURGERY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN BONNET MD, DDS (PRESIDENT)
(214) 226-3980
Entity
Organization
Contact information
Practice address
3610 CAPITAL AVE SW, BATTLE CREEK, MI 49015-9354
(269) 965-1339
Mailing address
3610 CAPITAL AVE SW, BATTLE CREEK, MI 49015-9354
(269) 965-1339
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
2901020237
MI
Other
Enumeration date
05/24/2016
Last updated
10/14/2016
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