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General NPI Number Information
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NPI Number | 1861583056
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Entity Type | Individual
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Provider Name | ZIGMUND PAUL BOGUCKI DDS MSD
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Gender | Male
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Dates
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Enumeration Date | 09/27/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 494 NEWARK-POMPTON TURNPIKE
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City | POMPTON PLAINS
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State | NJ
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Zip | 07444-1925
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Country | US
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Telephone | 973-839-1237
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Fax | 973-839-1247
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Provider Business Mailing Address
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Address Line | 494 NEWARK-POMPTON TURNPIKE
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City | POMPTON PLAINS
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State | NJ
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Zip | 07444-1925
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Country | US
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Telephone | 973-839-1237
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Fax | 973-839-1247
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 22DI00804600
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 24285
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DS015041L
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License Number State | PA
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