Healthcare Provider Details

I. General information

NPI: 1982827770
Provider Name (Legal Business Name): BRENT R HOGGAN D.D.S.,M.S.,P.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 W DRY CREEK CIR SUITE 310
LITTLETON CO
80120-8063
US

IV. Provider business mailing address

26 W DRY CREEK CIR SUITE 310
LITTLETON CO
80120-8063
US

V. Phone/Fax

Practice location:
  • Phone: 303-730-2083
  • Fax: 303-730-6854
Mailing address:
  • Phone: 303-730-2083
  • Fax: 303-730-6854

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number8033
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: