Provider Demographics
NPI:1336630599
Name:STEVEN FRANK BOGART DDS AND HUBERT GUGALA DMD
Entity Type:Organization
Organization Name:STEVEN FRANK BOGART DDS AND HUBERT GUGALA DMD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:FRANK
Authorized Official - Last Name:BOGART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-852-3100
Mailing Address - Street 1:57 ROUTE 46 SUITE 207
Mailing Address - Street 2:
Mailing Address - City:HACKETTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07860
Mailing Address - Country:US
Mailing Address - Phone:908-852-3100
Mailing Address - Fax:908-852-6418
Practice Address - Street 1:57 ROUTE 46 SUITE 207
Practice Address - Street 2:
Practice Address - City:HACKETTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07860
Practice Address - Country:US
Practice Address - Phone:908-852-3100
Practice Address - Fax:908-852-6418
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-23
Last Update Date:2018-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI01712700204E00000X
NJ22DI02405804204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial SurgeryGroup - Single Specialty