Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. BONITA LYNN PRUITT, DDS
ActiveDR. BONITA LYNN PRUITT, DDS is a Pediatric Dentistry healthcare provider located in FORT DRUM, New York. NPI 1770562415 is currently active in the NPPES registry. Verify at CMS.
Pediatric Dentistry · FORT DRUM, NY
Registration Details
- NPI Number
- 1770562415
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jan 11, 2006 (20.406480310472 yrs)
- Last Updated
- Jul 8, 2007
- License
-
14977 (TX)
Practice Information
- Address
-
US ARMY DENTAL ACTIVITY ATTN CREDENTIALS COORDINATOR10205 NORTH RIVA RIDGE LOOPFORT DRUM, NY, 136035005Browse NY providers · Browse ZIP 13603
- Phone
- 3157724342
- Fax
- 3157729692
- Primary Specialty
-
Pediatric Dentistry
1223P0221X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.