Healthcare Provider Details

I. General information

NPI: 1831475300
Provider Name (Legal Business Name): ZOO DENTAL, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2011
Last Update Date: 10/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2412 N CONWAY AVE
MISSION TX
78574-2347
US

IV. Provider business mailing address

2412 N CONWAY AVE
MISSION TX
78574-2347
US

V. Phone/Fax

Practice location:
  • Phone: 956-585-0300
  • Fax: 956-585-4355
Mailing address:
  • Phone: 956-585-0300
  • Fax: 956-585-4355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. SERGEY BONDAR
Title or Position: DENTIST
Credential: D.D.S.
Phone: 956-585-0300