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NPI Code Detail

MEDICARE: DR. DOCIA ANN HOGAN DDS

MEDICARE: DR. DOCIA ANN HOGAN DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice DentistryD11899MN

General Provider Information

NPI Number : 1144306101
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DOCIA ANN HOGAN DDS
Provider Business Mailing Address
First Line : 2096 OAKWOOD DR
Second Line :
City : MOUNDS VIEW
State : MN
Zip : 55112-1248
Country : US
Telephone Number : 612-382-8567
Fax Number :
Provider Business Practice Location Address
First Line : 12233 CHAMPLIN DR
Second Line :
City : CHAMPLIN
State : MN
Zip : 55316-1930
Country : US
Telephone Number : 763-323-0678
Fax Number : 763-323-9102
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/31/2006
Last Update Date : 05/21/2009

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Directions to “ DR. DOCIA ANN HOGAN DDS” Practice Location

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