Provider Demographics
NPI:1871660241
Name:BOGERS, JOHN E (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:E
Last Name:BOGERS
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 1:1026 20TH ST
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25703-2059
Mailing Address - Country:US
Mailing Address - Phone:304-523-4141
Mailing Address - Fax:304-523-0846
Practice Address - Street 1:1026 20TH ST
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25703-2059
Practice Address - Country:US
Practice Address - Phone:304-523-4141
Practice Address - Fax:304-523-0846
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2227122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist