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General NPI Number Information
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NPI Number | 1962615823
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Entity Type | Organization
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Legal Business Name | TEODORA T. BONNEY, DMD, PC
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Dates
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Enumeration Date | 05/08/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5080 E JONESTOWN ROAD
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City | HARRISBURG
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State | PA
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Zip | 17112
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Country | US
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Telephone | 717-540-1182
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Fax | 717-540-1531
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Provider Business Mailing Address
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Address Line | 5080 E JONESTOWN ROAD
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City | HARRISBURG
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State | PA
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Zip | 17112
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Country | US
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Telephone | 717-540-1182
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Fax | 717-540-1531
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. PHYLLIS M ADAMS
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Credential |
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Telephone | 717-731-3466
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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 | DS029483L
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License Number State | PA
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