Provider Demographics
NPI:1689713885
Name:SONNES, BOB A (DDS)
Entity Type:Individual
Prefix:
First Name:BOB
Middle Name:A
Last Name:SONNES
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:406 SE 131ST AVE
Mailing Address - Street 2:STE 305C
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98683-4004
Mailing Address - Country:US
Mailing Address - Phone:360-253-9792
Mailing Address - Fax:360-604-5266
Practice Address - Street 1:406 SE 131ST AVE
Practice Address - Street 2:STE 305C
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98683-4004
Practice Address - Country:US
Practice Address - Phone:360-253-9792
Practice Address - Fax:360-604-5266
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE00060241223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics