Individual
MICHAEL LEE BOND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
603 S MAIN ST, GRETNA, VA 24557
(434) 656-3573
(434) 565-3573
Mailing address
PO BOX 558, GRETNA, VA 24557
(434) 656-3573
(434) 656-3573
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401005648
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
78-1741-0
—
VA
Enumeration date
10/04/2006
Last updated
07/08/2007
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