Provider Demographics
NPI:1194847087
Name:BONDAR, STELLA S (DMD)
Entity Type:Individual
Prefix:MRS
First Name:STELLA
Middle Name:S
Last Name:BONDAR
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1261 FURNACE BROOK PKWY
Mailing Address - Street 2:ST 27
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-4721
Mailing Address - Country:US
Mailing Address - Phone:617-472-1287
Mailing Address - Fax:617-472-1288
Practice Address - Street 1:1261 FURNACE BROOK PKWY
Practice Address - Street 2:ST 27
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-4721
Practice Address - Country:US
Practice Address - Phone:617-472-1287
Practice Address - Fax:617-472-1288
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA199751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice