Provider Demographics
NPI:1366513145
Name:BOND, MICHAEL EDWARD (DDS)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:EDWARD
Last Name:BOND
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 N WASHINGTON ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-4541
Mailing Address - Country:US
Mailing Address - Phone:630-983-6605
Mailing Address - Fax:630-983-9605
Practice Address - Street 1:200 N WASHINGTON ST
Practice Address - Street 2:SUITE 102
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-4555
Practice Address - Country:US
Practice Address - Phone:630-983-6605
Practice Address - Fax:630-983-9605
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice