Julia Bonks, D.D.S.

Individual provider Active NPI Pediatric Dentistry · Derby, CT

NPI 1780835637 · NPPES record last updated Dec 7, 2015

Key facts

NPI
1780835637
Entity type
Individual (NPI type 1)
Primary specialty
Pediatric Dentistry 1223P0221X
License
011125 (CT)
Practice address
36 Division St
Derby, CT 06418-1447
Phone
(551) 206-9205
NPI assigned
Oct 8, 2008
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
011125CTMDPediatric Physical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 011125 CT Yes

Addresses

Primary practice location

36 Division St
Derby, CT 06418-1447

Mailing address

36 Division St
Derby, CT 06418-1447
Phone (551) 206-9205

Other providers in Derby, CT

All providers in Derby, CT · Pediatric Dentistry in Connecticut

Sources for this page

Verify at the official NPI Registry.