Mr Mark R Bognar, DDS | |
E 23970 Pow Wow Trail Rd, Lac Vieux Desert Health Center, Watersmeet, MI 49969-0249 | |
(906) 358-4587 | |
(906) 358-4118 |
Full Name | Mr Mark R Bognar |
---|---|
Gender | Male |
Speciality | Dentist |
Location | E 23970 Pow Wow Trail Rd, Watersmeet, Michigan |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1952319832 | NPI | - | NPPES |
33731100 | Medicaid | WI | |
45575 | Other | WI | SECURITY HEALTH PLAN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 3856015 (Wisconsin) | Secondary |
122300000X | Dentist | 2901019957 (Michigan) | Primary |
Mailing Address | Practice Location Address |
---|---|
Mr Mark R Bognar, DDS Po Box 249, Watersmeet, MI 49969-0249 Ph: (906) 358-4587 | Mr Mark R Bognar, DDS E 23970 Pow Wow Trail Rd, Lac Vieux Desert Health Center, Watersmeet, MI 49969-0249 Ph: (906) 358-4587 |
Rebecca Larson, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: N5241 Us Highway 45, Watersmeet, MI 49969 Phone: 906-358-4931 | |
Maurice Anthony Shively, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: E23970 Pow Wow Trail Rd, Watersmeet, MI 49969 Phone: 906-358-4587 Fax: 906-358-4118 |