Provider Demographics
NPI:1437243441
Name:BONSI, PROSPER KORI (DMD)
Entity Type:Individual
Prefix:DR
First Name:PROSPER
Middle Name:KORI
Last Name:BONSI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:482 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ONEONTA
Mailing Address - State:NY
Mailing Address - Zip Code:13820
Mailing Address - Country:US
Mailing Address - Phone:607-433-1129
Mailing Address - Fax:607-433-5208
Practice Address - Street 1:482 MAIN ST
Practice Address - Street 2:
Practice Address - City:ONEONTA
Practice Address - State:NY
Practice Address - Zip Code:13820
Practice Address - Country:US
Practice Address - Phone:607-433-1472
Practice Address - Fax:607-433-5208
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2012-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY048992122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist