| Earl Bogrow Dds Pc | |
|
28411 Northwestern Hwy Ste 230 Southfield MI 48034-5548 | |
| (248) 827-1900 | |
| (248) 827-0949 |
| Full Name | Earl Bogrow Dds Pc |
|---|---|
| Speciality | Dentist |
| Location | 28411 Northwestern Hwy Ste 230, Southfield, Michigan |
| Authorized Official Name and Position | Earl K. Bogrow (PRESIDENT OWNER) |
| Authorized Official Contact | 2488271900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Earl Bogrow Dds Pc 28411 Northwestern Hwy Ste 225 Southfield MI 48034-5508 Ph: (248) 827-1900 | Earl Bogrow Dds Pc 28411 Northwestern Hwy Ste 230 Southfield MI 48034-5548 Ph: (248) 827-1900 |
| NPI Number | 1225347081 |
|---|---|
| Provider Enumeration Date | 09/28/2010 |
| Last Update Date | 09/25/2023 |
| Medicare PECOS PAC ID | 5395938799 |
|---|---|
| Medicare Enrollment ID | O20101018001179 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225347081 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | L1376041 (Michigan) | Primary |
| 335E00000X | Prosthetic/orthotic Supplier | L1376041 (Michigan) | Secondary |
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