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General NPI Number Information
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NPI Number | 1043427321
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Entity Type | Individual
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Provider Name | BAHMAN VOJDANI D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/17/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 100 BLACKHORSE PIKE SUITE D-4 AUDUBON ORAL HEALTH CENTER
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City | AUDUBON
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State | NJ
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Zip | 08106
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Country | US
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Telephone | 856-546-1942
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Fax | 856-546-7305
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Provider Business Mailing Address
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Address Line | 129 HEARTHSTONE LANE
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City | MARLTON
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State | NJ
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Zip | 08053
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Country | US
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Telephone | 856-546-1942
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Fax | 856-546-7305
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 22DI02007800
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License Number State | NJ
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