Provider Demographics
NPI:1851862569
Name:BONKOWSKI DENTAL, P.C.
Entity Type:Organization
Organization Name:BONKOWSKI DENTAL, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:BONKOWSKI
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:413-562-9110
Mailing Address - Street 1:37 MEADOW ST
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01085-3241
Mailing Address - Country:US
Mailing Address - Phone:413-562-9110
Mailing Address - Fax:413-572-4610
Practice Address - Street 1:37 MEADOW ST
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:MA
Practice Address - Zip Code:01085-3241
Practice Address - Country:US
Practice Address - Phone:413-562-9110
Practice Address - Fax:413-572-4610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-07
Last Update Date:2018-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty