Healthcare Provider Details

I. General information

NPI: 1568620797
Provider Name (Legal Business Name): RICK L OGUREK DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2008
Last Update Date: 05/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

EAST JERSEY STATE PRISON LOCKBAG R
RAHWAY NJ
07065
US

IV. Provider business mailing address

26 INNERHILL LN
ABERDEEN NJ
07747-1717
US

V. Phone/Fax

Practice location:
  • Phone: 732-396-0492
  • Fax:
Mailing address:
  • Phone: 732-290-8345
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number22DI01532800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: