Individual provider · NPI-1

Dr. David James Bohannan, DMD

Dentist · Bedford, TX

NPI number1285731349
StatusActive
Last updated in NPPESJul 8, 2007

Details

NPI
1285731349
Entity type
Individual (NPI-1)
Name
Dr. David James Bohannan
Credential
DMD
Sex
Male
Sole proprietor
No
Enumeration date
Sep 20, 2006
Last updated
Jul 8, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
122300000X Dentist22878TXYes

Practice location

1404 Brown Trail
Suite E
Bedford, TX 76022-6417

Phone 817-282-6751

Mailing address

1404 Brown Trail
Suite E
Bedford, TX 76022-6417

Phone 817-282-6751

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