MEDICARE: DR. JEFFREY TAYLOR BOND DDS,

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	6311	WA

General Provider Information

NPI Number	:	1174582027
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY TAYLOR BOND DDS,

Provider Business Mailing Address
First Line	:	4151 FAUNTLEROY WAY SW
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98126-2672
Country	:	US
Telephone Number	:	206-932-1104
Fax Number	:	206-932-2193

Provider Business Practice Location Address
First Line	:	4151 FAUNTLEROY WAY SW
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98126-2672
Country	:	US
Telephone Number	:	206-932-1104
Fax Number	:	206-932-2193

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/20/2006
Last Update Date	:	07/08/2007

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