Provider Demographics
NPI:1578844544
Name:BONNETT, KYRA LYNNE
Entity Type:Individual
Prefix:MS
First Name:KYRA
Middle Name:LYNNE
Last Name:BONNETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5627 N HEMLOCK ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99205-7049
Mailing Address - Country:US
Mailing Address - Phone:509-981-6288
Mailing Address - Fax:
Practice Address - Street 1:5627 N HEMLOCK ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99205-7049
Practice Address - Country:US
Practice Address - Phone:509-981-6288
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-06
Last Update Date:2011-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant