Provider Demographics
NPI:1942721428
Name:NEGRUT, BOGDAN NICOLAE (DMD)
Entity Type:Individual
Prefix:DR
First Name:BOGDAN
Middle Name:NICOLAE
Last Name:NEGRUT
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 1:2543 SW CONCH COVE LN
Mailing Address - Street 2:
Mailing Address - City:PALM CITY
Mailing Address - State:FL
Mailing Address - Zip Code:34990-2819
Mailing Address - Country:US
Mailing Address - Phone:954-478-4010
Mailing Address - Fax:
Practice Address - Street 1:2648 NW FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-9318
Practice Address - Country:US
Practice Address - Phone:772-324-3414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-05
Last Update Date:2017-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN228631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice