Jonar R Bonifacio, DDS Valid NPI
Individual provider · Dentist · Alpine, CA
- NPI
- 1164436705
- Type
- Individual (Type 1)
- Primary specialty
- Dentist
- Specialty group
- Dental Providers
- Taxonomy code
- 122300000X
- License number
- 47454 (CA)
- Sex
- Male
- Sole proprietor
- Yes
- Enumerated
- 2006-07-28
- Last updated
- 2017-04-26
Practice location
1620 Alpine Blvd, #121
Alpine, CA 91901-1102
(619) 445-8896