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General NPI Number Information
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NPI Number | 1801984141
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Entity Type | Individual
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Provider Name | TEODORA T BONNEY DMD
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Gender | Female
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Dates
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Enumeration Date | 10/11/2006
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Last Update Date | 04/19/2019
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Provider Practice Location Address
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Address Line | 1500 E BROWARD BLVD
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City | FT LAUDERDALE
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State | FL
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Zip | 33301
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Country | US
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Telephone | 954-463-4653
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Fax |
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Provider Business Mailing Address
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Address Line | 11210 HERON BAY BLVD APT 1116
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City | CORAL SPRINGS
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State | FL
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Zip | 33076-1616
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Country | US
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Telephone | 717-433-4779
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Fax |
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DN18518
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License Number State | FL
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