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Dr. Bonita Lynn Pruitt, DDS
Pediatric Dentist in Fort Drum, New York
NPI 1770562415

Bonita Lynn Pruitt is a Pediatric Dentist based in Fort Drum, NY and is specialized in Pediatric Dentistry. Bonita Lynn Pruitt practices in Fort Drum, NY and has the professional credentials of DDS. The NPI Number for Bonita Lynn Pruitt is 1770562415 and holds a License No. 14977 (New York).

The current practice location address for Bonita Lynn Pruitt is Us Army Dental Activity Attn Credentials Coordinator, Fort Drum, NY and can be reached out via phone at 315-772-4342 and via fax at 315-772-9692.

Location: Us Army Dental Activity Attn Credentials Coordinator, Fort Drum, NY, 13603-5005
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1770562415
Provider Name
Bonita Lynn Pruitt
Credential
DDS
Provider Entity Type
Individual
Gender
Female
Address
Us Army Dental Activity Attn Credentials Coordinator, Fort Drum, NY, 13603-5005
Phone Number
315-772-4342
Fax Number
315-772-9692
Provider Enumeration Date
01/11/2006
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
Us Army Dental Activity Attn Credentials Coordinator
City
Fort Drum
State
New York
Zip
13603-5005
Phone Number
315-772-4342
Fax Number
315-772-9692
person
Provider Business Mailing Address Details
Address
Us Army Dental Activity Attn Credentials Coordinator
City
Fort Drum
State
New York
Zip
13603-5005
Phone Number
315-772-4342
Fax Number
315-772-9692
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Pediatric Dentistry
Taxonomy
1223P0221X
License No.
14977 (Texas)
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
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