Individual
DR. BOGDAN NIKOLAYEVICH BODROUG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2701 NE 114TH AVE STE 6, VANCOUVER, WA 98684-4289
(360) 448-7018
(360) 828-5234
Mailing address
2701 NE 114TH AVE STE 6, VANCOUVER, WA 98684-4289
(360) 448-7018
(360) 828-5234
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D8513
OR
1223G0001X
General Practice Dentistry
DE00010445
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2028322
—
WA
Enumeration date
12/11/2006
Last updated
12/28/2015
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