Provider Demographics
NPI:1487644274
Name:BOND, PRISCILLA JOHNS (DMD)
Entity Type:Individual
Prefix:
First Name:PRISCILLA
Middle Name:JOHNS
Last Name:BOND
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 1:9710 PARK PLAZA AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40241-2285
Mailing Address - Country:US
Mailing Address - Phone:502-327-6380
Mailing Address - Fax:502-327-8650
Practice Address - Street 1:9710 PARK PLAZA AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40241-2285
Practice Address - Country:US
Practice Address - Phone:502-327-6380
Practice Address - Fax:502-327-8650
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY72261223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry