Provider Demographics
NPI:1508564030
Name:DR. LUKE W BOGDANOWICZ DDS AND ASSOCIATES LTD
Entity Type:Organization
Organization Name:DR. LUKE W BOGDANOWICZ DDS AND ASSOCIATES LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:LUKE
Authorized Official - Middle Name:
Authorized Official - Last Name:BOGDANOWICZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:763-425-5277
Mailing Address - Street 1:8525 EDINBROOK XING STE 402
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55443-3729
Mailing Address - Country:US
Mailing Address - Phone:763-425-5277
Mailing Address - Fax:
Practice Address - Street 1:8525 EDINBROOK XING STE 402
Practice Address - Street 2:
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55443-3729
Practice Address - Country:US
Practice Address - Phone:763-425-5277
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-23
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty