Russell Edward Bogacki DDS

NPI 1083605943 - Dentist - 1223G0001X

NPI Details
NPI 1083605943
Gender Male
Enumeration Date 10/31/2005
Last Updated 07/08/2007
Entity Type Individual
Active Over 11 years ago
Practice Location
8344 TRAFORD LN
SUITE 3D
SPRINGFIELD VA, 22152-1657, US
Phone (703) 451-2867
Fax (703) 991-8448
Business Location
8344 TRAFORD LN
SUITE 3D
SPRINGFIELD VA, 22152-1657, US
Phone (703) 451-2867
Fax (703) 991-8448
Toxanomy
Taxonomy Code 1223G0001X
License State Virginia
License Number 0401008712
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According to our database, Dr. Russell Edward Bogacki DDS NPI is 1083605943, taxonomy code is 1223G0001X and license number is 0401008712, license state is located at Virginia. Russell Edward Bogacki DDS physically located at 8344 Traford Ln, Springfield VA, 22152-1657. NPI Number Russell Edward Bogacki DDS has the Individual type.

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1083605943 NPI number is provided on an as is basis without warranty of any kind. 1083605943 is maintained by the National Plan & Provider Enumeration System. The contents of Russell Edward Bogacki DDS are for informational purposes only.