Bonvallet Family Dentistry, LLC
Organization Active NPI General Practice Dentistry · Pecatonica, IL
NPI 1306383872 · NPPES record last updated Jan 23, 2017
Key facts
- NPI
- 1306383872
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 019016389 (IL)
- Legal business name
- BONVALLET FAMILY DENTISTRY, LLC
- Practice address
- 727 Main St
Pecatonica, IL 61063-7740 - Phone
- (815) 239-1313
- NPI assigned
- Jan 23, 2017
- Organization subpart
- No
Authorized official
- Name
- Dr. Anna M Bonvallet, DMD
- Title
- Owner
- Phone
- (815) 239-1313
Practitioners 1
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry |
1223G0001X | 019016389 | IL | Yes |
Addresses
Primary practice location
727 Main St
Pecatonica, IL 61063-7740
Mailing address
727 Main St
PO Box 608
Pecatonica, IL 61063-7740
Phone (815) 239-1313
Other providers in Pecatonica, IL
- Kristi Abel
- Accelerated Rehabilitation Centers, LTD
- Kristina Bogue
- Nicole Dawn Diedrich
- Freeport Regional Health Care Foundation
- Jessica Gaither
- Kimberly A Goodnite
- Valerie Diane Heim
All providers in Pecatonica, IL · General Practice Dentistry in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 23, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.