Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223S0112X | Oral and Maxillofacial Surgeon | 040501 | NY |
Y | 1223S0112X | Oral and Maxillofacial Surgeon | DI01712700 | NJ |
NPI | 1023131810 |
---|---|
Provider Name | Dr. Steven F. Bogart |
First Address | Hackettstown, NJ 07840 |
Second Address | Hackettstown, NJ 07840 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2007 |
Last Update Date | 07/06/2013 |