NPI Index

DR. BONITA PRUITT, DDS

Dentist - Pediatric Dentistry

Active Individual
NPI: 1770562415

Practice Address

US ARMY DENTAL ACTIVITY ATTN CREDENTIALS COORDINATOR
10205 NORTH RIVA RIDGE LOOP
Fort Drum, NY 13603

Phone: (315) 772-4342

Specialties

Specialty Code Primary License
Dentist - Pediatric Dentistry 1223P0221X Yes 14977 (TX)

Frequently Asked Questions

NPI 1770562415 is the National Provider Identifier for DR. BONITA PRUITT, DDS, a Dentist - Pediatric Dentistry provider located in Fort Drum, NY. This NPI was enumerated on January 11, 2006.
DR. BONITA PRUITT, DDS practices at US ARMY DENTAL ACTIVITY ATTN CREDENTIALS COORDINATOR, 10205 NORTH RIVA RIDGE LOOP, Fort Drum, NY 13603.

Quick Facts

NPI
1770562415
Type
Individual
Enumerated
Jan 11, 2006
Last Updated
Jul 8, 2007

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