| Bonvallet Family Dentistry, Llc | |
|
727 Main St Pecatonica IL 61063-7740 | |
| (815) 239-1313 | |
| Not Available |
| Full Name | Bonvallet Family Dentistry, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 727 Main St, Pecatonica, Illinois |
| Authorized Official Name and Position | Anna M Bonvallet (OWNER) |
| Authorized Official Contact | 8152391313 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bonvallet Family Dentistry, Llc 727 Main St Po Box 608 Pecatonica IL 61063-7740 Ph: (815) 239-1313 | Bonvallet Family Dentistry, Llc 727 Main St Pecatonica IL 61063-7740 Ph: (815) 239-1313 |
| NPI Number | 1306383872 |
|---|---|
| Provider Enumeration Date | 01/23/2017 |
| Last Update Date | 01/23/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306383872 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 019016389 (Illinois) | Primary |