Individual
DR. ROBERT LUSK BONHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S. (DENTIST)
Contact information
Practice address
1222 L.W.E., SO. BEND, IN 46601
(574) 287-3300
(574) 287-3301
Mailing address
1222 LINCOLN WAY EAST, SO. BEND, IN 46601
(574) 287-3300
(574) 287-3301
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6474
IN
Other
Enumeration date
12/23/2010
Last updated
12/23/2010
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