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General NPI Number Information
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NPI Number | 1417385907
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Entity Type | Organization
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Legal Business Name | BODNAR & WYATT, PLLC
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Dates
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Enumeration Date | 10/22/2013
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Last Update Date | 04/28/2016
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Provider Practice Location Address
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Address Line | 900 HENDERSONVILLE RD SUITE 107
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City | ASHEVILLE
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State | NC
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Zip | 28803-1734
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Country | US
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Telephone | 828-277-6800
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Fax | 828-277-6820
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Provider Business Mailing Address
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Address Line | 900 HENDERSONVILLE RD SUITE 107
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City | ASHEVILLE
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State | NC
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Zip | 28803-1734
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Country | US
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Telephone | 828-277-6800
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Fax | 828-277-6820
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Authorized Official
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Title or Position | DISTRICT MANAGER
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Name | RENEE BENGE
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Credential | CDPMA
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Telephone | 828-627-1050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 7956
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License Number State | NC
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