Provider Demographics
NPI:1760677637
Name:ROBERT J HOGAN,DDS,PC
Entity Type:Organization
Organization Name:ROBERT J HOGAN,DDS,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:HOGAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:607-723-7373
Mailing Address - Street 1:123 MURRAY ST
Mailing Address - Street 2:
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13905-3005
Mailing Address - Country:US
Mailing Address - Phone:607-723-7373
Mailing Address - Fax:607-723-8841
Practice Address - Street 1:123 MURRAY ST
Practice Address - Street 2:
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13905-3005
Practice Address - Country:US
Practice Address - Phone:607-723-7373
Practice Address - Fax:607-723-8841
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-12
Last Update Date:2007-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031502261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental