Provider Demographics
NPI:1649598392
Name:OGILVIE, DENNIS GEORGE (DDS)
Entity Type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:GEORGE
Last Name:OGILVIE
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 1:1191 A SOUTH HEATON
Mailing Address - Street 2:
Mailing Address - City:KNOX
Mailing Address - State:IN
Mailing Address - Zip Code:46534
Mailing Address - Country:US
Mailing Address - Phone:574-772-7720
Mailing Address - Fax:
Practice Address - Street 1:1191 A SOUTH HEATON
Practice Address - Street 2:
Practice Address - City:KNOX
Practice Address - State:IN
Practice Address - Zip Code:46534
Practice Address - Country:US
Practice Address - Phone:574-772-7720
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-05
Last Update Date:2015-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12012220A1223G0001X
WI390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program