| North Orange Family Dentistry, Kyle D. Bogan, Dds, Llc | |
|
7325 Gooding Blvd Delaware OH 43015-7086 | |
| (740) 548-1800 | |
| (740) 548-1804 |
| Full Name | North Orange Family Dentistry, Kyle D. Bogan, Dds, Llc |
|---|---|
| Speciality | Dentist |
| Location | 7325 Gooding Blvd, Delaware, Ohio |
| Authorized Official Name and Position | Kyle Dean Bogan (OWNER/SOLE MEMBER) |
| Authorized Official Contact | 7405481800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| North Orange Family Dentistry, Kyle D. Bogan, Dds, Llc 7325 Gooding Blvd Delaware OH 43015-7086 Ph: (740) 548-1800 | North Orange Family Dentistry, Kyle D. Bogan, Dds, Llc 7325 Gooding Blvd Delaware OH 43015-7086 Ph: (740) 548-1800 |
| NPI Number | 1568706091 |
|---|---|
| Provider Enumeration Date | 11/21/2012 |
| Last Update Date | 04/26/2021 |
| Medicare PECOS PAC ID | 1658658315 |
|---|---|
| Medicare Enrollment ID | O20210526000462 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568706091 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 30-022770 (Ohio) | Primary |
| 332B00000X | Durable Medical Equipment & Medical Supplies | (* (Not Available)) | Secondary |
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