Misiak, Bonnie

Misiak, Bonnie is an individual health care provider with primary practice located at 115 K D Revell Rd , Wauchula FL 33873-2051. She recently has 2 registered licenses in different health care specialties including Dental Providers / Dental Public Health, Dental Providers / Dental Hygienist. Dental Providers / Dental Public Health is her primary health care specialty. Misiak, Bonnie can be contacted via phone (863) 773-4161.

Contact Information

Primary practice address
115 K D Revell Rd Wauchula FL 33873-2051
Phone: (863) 773-4161
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dental Public Health 1223D0001X DN16641 Florida
Dental Providers / Dental Hygienist 124Q00000X DH17043 Florida

Profile Details

NPI number 1699877860
LBN Legal business name Misiak, Bonnie
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 1st, 2006
Last updated Mar 7th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699877860 NPPES
Florida Other DH17043 DH LICENSE
Florida MEDICAID 027924211 DH LICENSE
Florida Other DN16641 DH LICENSE

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