Individual
JASON BODNAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
103 HAYWOOD PARK DR, CLYDE, NC 28721-4405
(828) 627-1050
(828) 627-1056
Mailing address
4 SAWYERS PHEASANT LANE, CANDLER, NC 28715-5108
(828) 230-4685
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7956
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1702701
UNITED CONCORDIA
PA
05
—
5901866
—
NC
01
—
9025V
BCBS
NC
Enumeration date
07/24/2006
Last updated
10/02/2013
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