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General NPI Number Information
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NPI Number | 1770700650
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Entity Type | Organization
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Legal Business Name | BOGDAN ORTHODONTICS
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Dates
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Enumeration Date | 04/20/2007
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Last Update Date | 03/31/2008
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Provider Practice Location Address
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Address Line | 552 BROADWAY
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City | BAYONNE
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State | NJ
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Zip | 07002-3825
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Country | US
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Telephone | 201-436-0707
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Fax | 201-436-6224
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Provider Business Mailing Address
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Address Line | 552 BROADWAY
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City | BAYONNE
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State | NJ
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Zip | 07002-8831
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Country | US
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Telephone | 201-436-0707
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Fax | 201-436-6224
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. FRANK A. BOGDAN
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Credential | D.M.D.
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Telephone | 201-436-0707
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DI009660
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License Number State | NJ
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