Provider Demographics
NPI:1174144851
Name:ROBERT A. BOND, D.D.S.
Entity type:Organization
Organization Name:ROBERT A. BOND, D.D.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS RECEPTIONIST
Authorized Official - Prefix:
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:AMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-235-3205
Mailing Address - Street 1:2851 UNIVERSITY DR S
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-6029
Mailing Address - Country:US
Mailing Address - Phone:701-235-3205
Mailing Address - Fax:
Practice Address - Street 1:2851 UNIVERSITY DR S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-6029
Practice Address - Country:US
Practice Address - Phone:701-235-3205
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-04
Last Update Date:2020-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty