MRS. Kathleen Susan Bonilla, RDH

NPI #1962533505 in Coppell, Texas

Provider Information

NPI Number: 1962533505
Entity Type: Individual
Name: MRS. Kathleen Susan Bonilla, RDH
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dental Hygienist
Credential: RDH
Enumeration Date: Mar 7, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 120 S DENTON TAP RD
Address 2: SUITE #100
City: Coppell
State: Texas
ZIP Code: 75019-3297
Phone: (469) 635-1105

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dental Hygienist	124Q00000X	Primary

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