Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 2901014555 | MI |
NPI | 1225332364 |
---|---|
Provider Name | Dr. Bonita Davis Neighbors |
First Address | Saline, MI 48176-8010 |
Second Address | Saline, MI 48176-8010 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2011 |
Last Update Date | 04/01/2011 |