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General NPI Number Information
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NPI Number | 1649324104
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Entity Type | Organization
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Legal Business Name | BONDS FAMILY DENTISTRY, INC
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Dates
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Enumeration Date | 01/22/2007
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Last Update Date | 02/03/2009
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Provider Practice Location Address
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Address Line | 1919 W MAIN ST
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City | RUSSELLVILLE
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State | AR
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Zip | 72801-2725
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Country | US
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Telephone | 479-880-2311
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Fax | 479-880-2281
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Provider Business Mailing Address
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Address Line | 1919 W MAIN ST
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City | RUSSELLVILLE
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State | AR
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Zip | 72801-2725
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Country | US
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Telephone | 479-880-2311
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Fax | 479-880-2281
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JAMES DUSTIN BONDS
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Credential | DDS
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Telephone | 479-880-2311
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | AR 3331
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License Number State | AR
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