MEDICARE: MS. REBECCA BONNEY RDH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	124Q00000X	Dental Hygienist	RDH2737	ME

General Provider Information

NPI Number	:	1588898613
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. REBECCA BONNEY RDH

Provider Business Mailing Address
First Line	:	464 BENTON AVE
Second Line	:
City	:	WINSLOW
State	:	ME
Zip	:	04901-3015
Country	:	US
Telephone Number	:	207-872-7833
Fax Number	:

Provider Business Practice Location Address
First Line	:	464 BENTON AVE
Second Line	:
City	:	WINSLOW
State	:	ME
Zip	:	04901-3015
Country	:	US
Telephone Number	:	207-872-7833
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/04/2009
Last Update Date	:	05/04/2009

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