Provider Demographics
NPI:1407103419
Name:SONYA-HOGLUND, DOROTNY (DMD, MSC, DIP ORTHO)
Entity Type:Individual
Prefix:DR
First Name:DOROTNY
Middle Name:
Last Name:SONYA-HOGLUND
Suffix:
Gender:F
Credentials:DMD, MSC, DIP ORTHO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6321 NE RADFORD DR
Mailing Address - Street 2:SUITE 4513
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-8724
Mailing Address - Country:US
Mailing Address - Phone:206-747-6327
Mailing Address - Fax:
Practice Address - Street 1:1959 NE PACIFIC ST
Practice Address - Street 2:HSB - RM B316
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98195-6370
Practice Address - Country:US
Practice Address - Phone:206-747-6327
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-08
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADR602930151223X0008X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0008XDental ProvidersDentistOral and Maxillofacial Radiology