Organization
BRUCE BOHNSACK DDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRUCE ALLEN BOHNSACK DDS (DDS/OWNER)
(320) 286-5333
Entity
Organization
Contact information
Practice address
100 3RD ST SW, COKATO, MN 55321-4595
(320) 286-5333
(320) 286-5631
Mailing address
100 3RD ST SW, P.O. BOX 669, COKATO, MN 55321-4595
(320) 286-5333
(320) 286-5631
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D8315
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
972817100
—
MN
Enumeration date
10/04/2012
Last updated
10/24/2012
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