Provider Demographics
NPI:1699935296
Name:BOGDANOFF, ELAINE (DMD)
Entity type:Individual
Prefix:DR
First Name:ELAINE
Middle Name:
Last Name:BOGDANOFF
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 ROUTE 70 E
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034-2414
Mailing Address - Country:US
Mailing Address - Phone:856-429-9419
Mailing Address - Fax:856-429-9178
Practice Address - Street 1:411 ROUTE 70 E
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-2414
Practice Address - Country:US
Practice Address - Phone:856-429-9419
Practice Address - Fax:856-429-9178
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-17
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ155541223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics