Individual
DR. BOGDAN KONSTANTINOV IVANOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
1105 E KENNEDY BLVD, SCC DENTAL CLINIC - HCHD, TAMPA, FL 33602-3511
(352) 397-6186
(813) 273-3721
Mailing address
1105 E KENNEDY BLVD, SCC DENTAL CLINIC - HCHD, TAMPA, FL 33602-3511
(352) 397-6186
(813) 273-3721
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN17920
FL
Other
Enumeration date
10/29/2007
Last updated
03/31/2017
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