Bogner, Dallas

Bogner, Dallas is an individual health care provider with primary practice located at 1380 Tullar Rd , Neenah WI 54956-4440. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Bogner, Dallas can be contacted via phone (920) 727-3480.

Contact Information

Primary practice address
1380 Tullar Rd Neenah WI 54956-4440
Fax: (920) 727-3490
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X DR.0034837 Colorado
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 48225 Wisconsin

Profile Details

NPI number 1396780144
LBN Legal business name Bogner, Dallas
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 17th, 2006
Last updated Feb 7th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396780144 NPPES
Wisconsin MEDICAID 34683800

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