Provider Demographics
NPI:1851520456
Name:HOGAN, HELENA (DMD)
Entity Type:Individual
Prefix:DR
First Name:HELENA
Middle Name:
Last Name:HOGAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4403 W HILLSBORO BLVD
Mailing Address - Street 2:
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33073-3293
Mailing Address - Country:US
Mailing Address - Phone:954-405-9620
Mailing Address - Fax:
Practice Address - Street 1:4403 W HILLSBORO BLVD
Practice Address - Street 2:
Practice Address - City:COCONUT CREEK
Practice Address - State:FL
Practice Address - Zip Code:33073-3293
Practice Address - Country:US
Practice Address - Phone:954-405-9620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-06
Last Update Date:2017-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN18687122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist