Organization
BOGACKI & BOGACKI DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUSSELL EDWARD BOGACKI DDS (PRESIDENT)
(703) 451-2867
Entity
Organization
Contact information
Practice address
8344 TRAFORD LN, SPRINGFIELD, VA 22152-1657
(703) 451-2867
(703) 991-8448
Mailing address
8344 TRAFORD LN, SPRINGFIELD, VA 22152-1657
(703) 451-2867
(703) 991-8448
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401008712
VA
Other
Enumeration date
05/04/2007
Last updated
08/22/2020
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