MEDICARE: ORTHODONTIC SPECIALISTS-DRS. WELCH AND BONDS, P.A.

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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	2910	SC

General Provider Information

NPI Number	:	1710068390
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ORTHODONTIC SPECIALISTS-DRS. WELCH AND BONDS, P.A.

Provider Business Mailing Address
First Line	:	1343 2ND LOOP RD
Second Line	:
City	:	FLORENCE
State	:	SC
Zip	:	29505-2841
Country	:	US
Telephone Number	:	843-665-8176
Fax Number	:

Provider Business Practice Location Address
First Line	:	1343 2ND LOOP RD
Second Line	:
City	:	FLORENCE
State	:	SC
Zip	:	29505-2841
Country	:	US
Telephone Number	:	843-665-8176
Fax Number	:

Authorized Official
Title or Position	:	VICE-PRESIDENT
Name	:	PHILIP BONDS
Credential	:
Telephone Number	:	843-665-8176

Provider Enumeration Date	:	10/18/2006
Last Update Date	:	08/22/2020

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1740828904 — BONDS & PATTON ORTHODONTICS LLC
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