Healthcare Provider Details

I. General information

NPI: 1164806584
Provider Name (Legal Business Name): DANIELLE R BOND DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2015
Last Update Date: 08/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

77 MAIN ST
HOPKINTON MA
01748-3118
US

IV. Provider business mailing address

77 MAIN ST
HOPKINTON MA
01748-3118
US

V. Phone/Fax

Practice location:
  • Phone: 508-435-6500
  • Fax:
Mailing address:
  • Phone: 508-435-6500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN1857158
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN1857158
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: