Provider Demographics
NPI:1003981978
Name:JAMES B. BOGGS, D.D.S., P.A.
Entity Type:Organization
Organization Name:JAMES B. BOGGS, D.D.S., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:BOXLEY
Authorized Official - Last Name:BOGGS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:828-396-6882
Mailing Address - Street 1:4283 HICKORY BLVD
Mailing Address - Street 2:
Mailing Address - City:GRANITE FALLS
Mailing Address - State:NC
Mailing Address - Zip Code:28630-1990
Mailing Address - Country:US
Mailing Address - Phone:828-396-6882
Mailing Address - Fax:828-396-5787
Practice Address - Street 1:4283 HICKORY BLVD
Practice Address - Street 2:
Practice Address - City:GRANITE FALLS
Practice Address - State:NC
Practice Address - Zip Code:28630-1990
Practice Address - Country:US
Practice Address - Phone:828-396-6882
Practice Address - Fax:828-396-5787
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-23
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC67971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty