Provider Demographics
NPI:1336296185
Name:BONDAD, PATRICK H (DDS)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:H
Last Name:BONDAD
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 1:352 E RIVERSIDE DR
Mailing Address - Street 2:STE C2
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-6758
Mailing Address - Country:US
Mailing Address - Phone:435-688-7171
Mailing Address - Fax:
Practice Address - Street 1:352 E RIVERSIDE DR
Practice Address - Street 2:STE C2
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-6758
Practice Address - Country:US
Practice Address - Phone:435-688-7171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5850281-99211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice