Provider Demographics
NPI:1710068390
Name:ORTHODONTIC SPECIALISTS-DRS. WELCH AND BONDS, P.A.
Entity Type:Organization
Organization Name:ORTHODONTIC SPECIALISTS-DRS. WELCH AND BONDS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:
Authorized Official - Last Name:BONDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-665-8176
Mailing Address - Street 1:1343 2ND LOOP RD
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29505-2841
Mailing Address - Country:US
Mailing Address - Phone:843-665-8176
Mailing Address - Fax:
Practice Address - Street 1:1343 2ND LOOP RD
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29505-2841
Practice Address - Country:US
Practice Address - Phone:843-665-8176
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC29101223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty