Provider Demographics
NPI:1043427321
Name:VOJDANI, BAHMAN (DMD)
Entity Type:Individual
Prefix:DR
First Name:BAHMAN
Middle Name:
Last Name:VOJDANI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 HEARTHSTONE LANE
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053
Mailing Address - Country:US
Mailing Address - Phone:856-546-1942
Mailing Address - Fax:856-546-7305
Practice Address - Street 1:100 BLACKHORSE PIKE
Practice Address - Street 2:SUITE D-4 AUDUBON ORAL HEALTH CENTER
Practice Address - City:AUDUBON
Practice Address - State:NJ
Practice Address - Zip Code:08106
Practice Address - Country:US
Practice Address - Phone:856-546-1942
Practice Address - Fax:856-546-7305
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02007800122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist