Provider Demographics
NPI:1033521836
Name:BERTRAND A BONNICK DDS PLLC
Entity type:Organization
Organization Name:BERTRAND A BONNICK DDS PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BERTRAND
Authorized Official - Middle Name:A
Authorized Official - Last Name:BONNICK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:336-591-4303
Mailing Address - Street 1:PO BOX 648
Mailing Address - Street 2:
Mailing Address - City:WALNUT COVE
Mailing Address - State:NC
Mailing Address - Zip Code:27052
Mailing Address - Country:US
Mailing Address - Phone:336-591-4303
Mailing Address - Fax:336-591-4516
Practice Address - Street 1:2783 NC HIGHWAY 68 S
Practice Address - Street 2:SUITE #107
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27265-8324
Practice Address - Country:US
Practice Address - Phone:336-841-0000
Practice Address - Fax:336-841-0001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-28
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC076721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty