Provider Demographics
NPI:1639610678
Name:DOGAR, MOHAMMAD ISMAIL (DMD)
Entity Type:Individual
Prefix:DR
First Name:MOHAMMAD
Middle Name:ISMAIL
Last Name:DOGAR
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 1:916 BELVIDERE RD
Mailing Address - Street 2:
Mailing Address - City:BELVIDERE
Mailing Address - State:IL
Mailing Address - Zip Code:61008-9360
Mailing Address - Country:US
Mailing Address - Phone:815-544-3111
Mailing Address - Fax:
Practice Address - Street 1:916 BELVIDERE RD
Practice Address - Street 2:
Practice Address - City:BELVIDERE
Practice Address - State:IL
Practice Address - Zip Code:61008-9360
Practice Address - Country:US
Practice Address - Phone:815-544-3111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-09
Last Update Date:2019-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019031883122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist