NPI 1184980914

Fredric L. Bonine, DDS, Ms, PC

Organisation Preferred Provider Organization Brighton, MI

Practice location

Address: 6893 Grand River Rd, Brighton, MI 48114-9345
Phone: (810) 229-9180
Fax: (810) 229-1880

Authorised official

Name: Fredric L. Bonine
Title: Sole Proprietor
Phone: (810) 229-9180

Registered specialties

Preferred Provider Organization Primary

Managed Care Organizations Taxonomy 305R00000X Licence 2901012106 (MI)

Other Preferred Provider Organization providers in Michigan →

Registry record

NPI: 1184980914
Entity type: Organization
NPI issued: 5 Apr 2012
Record last updated: 22 May 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.