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General NPI Number Information
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NPI Number | 1518310325
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Entity Type | Organization
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Legal Business Name | JAMES P HOGG DDS PLLC
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Dates
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Enumeration Date | 07/16/2016
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Last Update Date | 07/16/2016
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Provider Practice Location Address
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Address Line | 155 NE 192ND AVE SUITE 105
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City | CAMAS
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State | WA
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Zip | 98607-7477
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Country | US
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Telephone | 360-828-5502
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Fax |
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Provider Business Mailing Address
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Address Line | 155 NE 192ND AVE SUITE 105
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City | CAMAS
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State | WA
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Zip | 98607-7477
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Country | US
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Telephone | 360-828-5502
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JAMES PALMER HOGG
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Credential | DDS
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Telephone | 360-828-5502
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | DE00007386
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License Number State | WA
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