Provider Demographics
NPI:1174688196
Name:HAROLD S KOGOD DDS PC
Entity Type:Organization
Organization Name:HAROLD S KOGOD DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHODONTIST PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:STEPHEN
Authorized Official - Last Name:KOGOD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:301-983-2515
Mailing Address - Street 1:10540 DEMOCRACY BLVD
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854
Mailing Address - Country:US
Mailing Address - Phone:301-953-2515
Mailing Address - Fax:301-983-0153
Practice Address - Street 1:10540 DEMOCRACY BLVD
Practice Address - Street 2:
Practice Address - City:POTOMAC
Practice Address - State:MD
Practice Address - Zip Code:20854
Practice Address - Country:US
Practice Address - Phone:301-953-2515
Practice Address - Fax:301-983-0153
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD9656122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty