MRS. Bonnie Jean Devall, LICENSED DENTURIST

NPI #1720124324 in Twin Falls, Idaho

Provider Information

NPI Number: 1720124324
Entity Type: Individual
Name: MRS. Bonnie Jean Devall, LICENSED DENTURIST
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Denturist
Credential: LICENSED DENTURIST
Enumeration Date: Jan 30, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 507 MAIN AVE W
Address 2: SUITE B
City: Twin Falls
State: Idaho
ZIP Code: 83301
Phone: (208) 733-2374

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Denturist	122400000X	Primary

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