Provider Demographics
NPI:1255055489
Name:NATALIE HOGUE D.D.S.
Entity type:Organization
Organization Name:NATALIE HOGUE D.D.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOGUE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-246-2544
Mailing Address - Street 1:230 N MARYLAND AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91206-4283
Mailing Address - Country:US
Mailing Address - Phone:818-246-2544
Mailing Address - Fax:818-246-2508
Practice Address - Street 1:230 N MARYLAND AVE STE 102
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91206-4283
Practice Address - Country:US
Practice Address - Phone:818-246-2544
Practice Address - Fax:818-246-2508
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-30
Last Update Date:2022-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
1639260466OtherNPI TYPE 1