Nwokocha, Bonaventure Chisom
Nwokocha, Bonaventure Chisom is an sole proprietor health care provider with primary practice located at 7960 Brooklyn Blvd , Brooklyn Park MN 55445-2722. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Nwokocha, Bonaventure Chisom can be contacted via phone (763) 710-9937.Contact Information
Primary practice address
7960 Brooklyn Blvd
Brooklyn Park MN 55445-2722
Phone: (763) 710-9937
Fax: (763) 710-9968
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | D12960 | Minnesota |
Profile Details
| NPI number | 1194018374 |
|---|---|
| LBN Legal business name | Nwokocha, Bonaventure Chisom |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 22nd, 2011 |
| Last updated | Sep 9th, 2020 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1194018374 | NPPES |
| Minnesota | MEDICAID | 1356749659 | |
| Minnesota | MEDICAID | 1174913339 |
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