Provider Demographics
NPI:1598234395
Name:JAMES W. KOGLIN, DDS LLC
Entity Type:Organization
Organization Name:JAMES W. KOGLIN, DDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:W
Authorized Official - Last Name:KOGLIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:978-290-3600
Mailing Address - Street 1:79 CURZON MILL RD
Mailing Address - Street 2:
Mailing Address - City:NEWBURYPORT
Mailing Address - State:MA
Mailing Address - Zip Code:01950-6251
Mailing Address - Country:US
Mailing Address - Phone:978-290-3600
Mailing Address - Fax:
Practice Address - Street 1:26 INN ST
Practice Address - Street 2:
Practice Address - City:NEWBURYPORT
Practice Address - State:MA
Practice Address - Zip Code:01950-2516
Practice Address - Country:US
Practice Address - Phone:978-290-3600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-21
Last Update Date:2018-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental