Provider Demographics
NPI:1851470884
Name:HIERS, BONNIE MARIE (DDS)
Entity Type:Individual
Prefix:DR
First Name:BONNIE
Middle Name:MARIE
Last Name:HIERS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5018 DORSEY HALL DR
Mailing Address - Street 2:SUITE 105
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-7855
Mailing Address - Country:US
Mailing Address - Phone:410-740-7008
Mailing Address - Fax:
Practice Address - Street 1:5018 DORSEY HALL DR
Practice Address - Street 2:SUITE 105
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-7855
Practice Address - Country:US
Practice Address - Phone:410-740-7008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD99561223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice