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Organization
BOGDAN N BODROUG, DDS, PS
Active
Organization
BOGDAN N BODROUG, DDS, PS
Active
Other names
Quality Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JILLIAN N GOOD-BODROUG RDA (ADMINISTRATOR)
(503) 490-1275
Entity
Organization
Contact information
Practice address
2701 NE 114TH AVE, SUITE 6, VANCOUVER, WA 98684-4289
(503) 427-2984
Mailing address
2701 NE 114TH AVE, SUITE 6, VANCOUVER, WA 98684-4289
(503) 427-2984
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DE00010445
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2001307
—
WA
Enumeration date
06/11/2013
Last updated
06/11/2013
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