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Individual

BRANDON FREDRIC BONINE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1515 E. HOSPITAL DRIVE, G1100 TOWSLEY CENTER, ANN ARBOR, MI 48109
(734) 232-6048
Mailing address
3216 GOLF CLUB RD, HOWELL, MI 48843-9001
(517) 861-0742

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901601400
MI

Other

Enumeration date
06/16/2022
Last updated
06/16/2022
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