Provider Demographics
NPI:1033277546
Name:NOGAY, JOHANNA SANTOS (DMD)
Entity Type:Individual
Prefix:
First Name:JOHANNA
Middle Name:SANTOS
Last Name:NOGAY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 ARROWHEAD CT
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:16105
Mailing Address - Country:US
Mailing Address - Phone:724-657-1941
Mailing Address - Fax:
Practice Address - Street 1:930 BOARDMAN POLAND RD
Practice Address - Street 2:ALLCARE DENTAL RT 224
Practice Address - City:BOARDMAN
Practice Address - State:OH
Practice Address - Zip Code:44512
Practice Address - Country:US
Practice Address - Phone:330-259-0276
Practice Address - Fax:330-758-8690
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30022049122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist