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General NPI Number Information
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NPI Number | 1609977743
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Entity Type | Individual
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Provider Name | LESLIE EUGENE BONNER DDS
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Gender | Male
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Dates
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Enumeration Date | 09/25/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1700 17TH ST NW SUITE 302
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City | WASHINGTON
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State | DC
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Zip | 20009-2453
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Country | US
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Telephone | 202-249-9131
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Fax | 202-249-2851
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Provider Business Mailing Address
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Address Line | 1700 17TH ST NW SUITE 302
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City | WASHINGTON
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State | DC
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Zip | 20009-2453
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Country | US
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Telephone | 202-249-9131
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Fax | 202-249-2851
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DEN 5997
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License Number State | DC
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