Provider Demographics
NPI:1003900580
Name:HOGAN, FREDERICK DAVID (DDS)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:DAVID
Last Name:HOGAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7590 N GILMORE RD
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45015
Mailing Address - Country:US
Mailing Address - Phone:513-737-7007
Mailing Address - Fax:513-868-9100
Practice Address - Street 1:2428 PLEASANT AVE
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45015
Practice Address - Country:US
Practice Address - Phone:513-868-9100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH179331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice