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General NPI Number Information
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NPI Number | 1932711769
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Entity Type | Individual
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Provider Name | HEATHER KATE BOGY DDS
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Gender | Female
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Dates
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Enumeration Date | 08/22/2020
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Last Update Date | 06/13/2024
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Provider Practice Location Address
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Address Line | 86-260 FARRINGTON HWY
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City | WAIANAE
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State | HI
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Zip | 96792-3128
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Country | US
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Telephone | 808-697-3300
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Fax |
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Provider Business Mailing Address
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Address Line | 149 NATALIE
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City | JEFFERSON
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State | AR
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Zip | 72079-9619
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Country | US
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Telephone | 870-489-4326
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Fax |
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | DEN.00204473
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DT-3165-0
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License Number State | HI
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