MEDICARE: MARCUS A. BOND DDS PLLC

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	122300000X	Dentist

General Provider Information

NPI Number	:	1275148553
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARCUS A. BOND DDS PLLC

Provider Business Mailing Address
First Line	:	1300 SOUTH BLVD STE A
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28203-0006
Country	:	US
Telephone Number	:	704-302-1919
Fax Number	:

Provider Business Practice Location Address
First Line	:	1300 SOUTH BLVD STE A
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28203-0006
Country	:	US
Telephone Number	:	704-302-1919
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. MARCUS ALAN BOND
Credential	:	DDS
Telephone Number	:	704-302-1919

Provider Enumeration Date	:	09/13/2020
Last Update Date	:	09/13/2020

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