Pruitt, Bonita Lynn

Pruitt, Bonita Lynn is an individual health care provider with primary practice located at Us Army Dental Activity Attn Credentials Coordinator 10205 North Riva Ridge Loop, Fort Drum NY 13603-5005. She recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as her primary health care specialty. Pruitt, Bonita Lynn can be contacted via phone (315) 772-4342.

Contact Information

Primary practice address
Us Army Dental Activity Attn Credentials Coordinator 10205 North Riva Ridge Loop Fort Drum NY 13603-5005
Phone: (315) 772-4342
Fax: (315) 772-9692
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X 14977 Texas

Profile Details

NPI number 1770562415
LBN Legal business name Pruitt, Bonita Lynn
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 11th, 2006
Last updated Jul 8th, 2007 - about 18 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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