Provider Demographics
NPI:1164657698
Name:BORDIGNON, JOSEPHINE DIFRANCO (RN, DDS)
Entity Type:Individual
Prefix:DR
First Name:JOSEPHINE
Middle Name:DIFRANCO
Last Name:BORDIGNON
Suffix:
Gender:F
Credentials:RN, DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 W. TALCOH
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068
Mailing Address - Country:US
Mailing Address - Phone:847-318-0066
Mailing Address - Fax:847-318-9574
Practice Address - Street 1:511 W. TALCOH
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068
Practice Address - Country:US
Practice Address - Phone:847-318-0066
Practice Address - Fax:847-318-9574
Is Sole Proprietor?:No
Enumeration Date:2009-05-28
Last Update Date:2009-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190220751223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics