Provider Demographics
NPI:1821011776
Name:HER, POGE (DDS)
Entity Type:Individual
Prefix:DR
First Name:POGE
Middle Name:
Last Name:HER
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 1:4433 FLORIN RD STE 790
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95823-2542
Mailing Address - Country:US
Mailing Address - Phone:916-428-0114
Mailing Address - Fax:916-423-8502
Practice Address - Street 1:4433 FLORIN RD STE 790
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-2542
Practice Address - Country:US
Practice Address - Phone:916-428-0114
Practice Address - Fax:916-423-8502
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2014-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA539961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice