Provider Demographics
NPI:1578780094
Name:BOGDEN, PAUL A (DMD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:A
Last Name:BOGDEN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 WESCOTT DRIVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822
Mailing Address - Country:US
Mailing Address - Phone:908-788-5001
Mailing Address - Fax:
Practice Address - Street 1:1 WESCOTT DR
Practice Address - Street 2:SUITE 202
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-4655
Practice Address - Country:US
Practice Address - Phone:908-788-5001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI010482001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice