Provider Demographics
NPI:1780200857
Name:BONE, ANEESA (DMD)
Entity Type:Individual
Prefix:
First Name:ANEESA
Middle Name:
Last Name:BONE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5947 HIGHWAY 269
Mailing Address - Street 2:
Mailing Address - City:PARRISH
Mailing Address - State:AL
Mailing Address - Zip Code:35580-3847
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5947 HIGHWAY 269
Practice Address - Street 2:
Practice Address - City:PARRISH
Practice Address - State:AL
Practice Address - Zip Code:35580-3847
Practice Address - Country:US
Practice Address - Phone:205-234-0537
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-24
Last Update Date:2020-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALD.0006756-C1122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist