| Bonvallet Dental, Pc | |
|
132 N Walnut St Byron IL 61010-8807 | |
| (815) 234-4211 | |
| Not Available |
| Full Name | Bonvallet Dental, Pc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 132 N Walnut St, Byron, Illinois |
| Authorized Official Name and Position | Justin Bonvallet (DENTIST/PRESIDENT) |
| Authorized Official Contact | 8152344211 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bonvallet Dental, Pc 132 N Walnut St Po Box 432 Byron IL 61010-8807 Ph: (815) 234-4211 | Bonvallet Dental, Pc 132 N Walnut St Byron IL 61010-8807 Ph: (815) 234-4211 |
| NPI Number | 1912265133 |
|---|---|
| Provider Enumeration Date | 04/25/2012 |
| Last Update Date | 04/25/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912265133 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 019027531 (Illinois) | Primary |