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Contact Information

JERRY L BONDURANT, DDS
1900 SCHOOL ST
KANAWHA DENTAL HEALTH COUNCIL INC
CHARLESTON, WV25312-1524
 Phone: 304-348-6613
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dentist

122300000X
Indicates primary specialty

NPI Profile & details for JERRY L BONDURANT · (Male)

NPI # 1902938863
Status Active
Credentials DDS (Doctor of Dental Surgery)
Entity Individual
Enumeration date 03/09/2007
Last updated 07/09/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • WV License # 1980
  • WV Medicaid 0012835000
  • WV Medicaid 0133364000
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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