Healthcare Provider Details

I. General information

NPI: 1356073837
Provider Name (Legal Business Name): MICHAEL ARTURO BOGRAN DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2022
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

423 N BRYANT AVE
EDMOND OK
73034-3207
US

IV. Provider business mailing address

423 N BRYANT AVE
EDMOND OK
73034-3207
US

V. Phone/Fax

Practice location:
  • Phone: 405-265-6659
  • Fax: 405-265-6658
Mailing address:
  • Phone: 405-265-6659
  • Fax: 405-265-6658

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number25522
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: