Provider Demographics
NPI:1841322039
Name:HOGAN, RICHARD IRVING
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:IRVING
Last Name:HOGAN
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:RICHARD
Other - Middle Name:IRVING
Other - Last Name:HOGAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:3130 COMMERCE PL
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215-5157
Mailing Address - Country:US
Mailing Address - Phone:336-584-9500
Mailing Address - Fax:336-584-1981
Practice Address - Street 1:3130 COMMERCE PL
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-5157
Practice Address - Country:US
Practice Address - Phone:336-584-9500
Practice Address - Fax:336-584-1981
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC48501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice