| NPI | 1184980914 |
|---|---|
| Doing Business As | FREDRIC L. BONINE, DDS, MS, PC |
| Entity Type | Organization |
| Authorized Contact | FREDRIC L. BONINE Sole Proprietor 810-229-9180 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: MI 2901012106) |
| Enumeration Date | 2012-04-05 |
| Last Update Date | 2012-05-22 |