Provider Demographics
NPI:1548759939
Name:POGREBAN, DORIN N (DC)
Entity Type:Individual
Prefix:DR
First Name:DORIN
Middle Name:N
Last Name:POGREBAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13869 IRONSTONE TRL NW
Mailing Address - Street 2:
Mailing Address - City:RAMSEY
Mailing Address - State:MN
Mailing Address - Zip Code:55303-4798
Mailing Address - Country:US
Mailing Address - Phone:763-439-6502
Mailing Address - Fax:
Practice Address - Street 1:2006 1ST AVE STE 204
Practice Address - Street 2:
Practice Address - City:ANOKA
Practice Address - State:MN
Practice Address - Zip Code:55303-2255
Practice Address - Country:US
Practice Address - Phone:763-421-0436
Practice Address - Fax:763-225-9985
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-02
Last Update Date:2018-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6495111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty