Provider Demographics
NPI:1487818480
Name:HOGAN, DONALD KEVIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:KEVIN
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 1:3405 SALTERBECK STREET
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29466-8332
Mailing Address - Country:US
Mailing Address - Phone:843-216-0908
Mailing Address - Fax:843-216-0324
Practice Address - Street 1:3405 SALTERBECK CT
Practice Address - Street 2:SUITE 100
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29466-7223
Practice Address - Country:US
Practice Address - Phone:843-216-0908
Practice Address - Fax:843-216-0324
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-18
Last Update Date:2012-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC30-039241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice