Mr Mark R Bognar, DDS is a medicare enrolled "Dentist" provider in Watersmeet, Michigan. His current practice location is
E 23970 Pow Wow Trail Rd, Lac Vieux Desert Health Center, Watersmeet, Michigan. You can reach out to his office (for appointments etc.) via phone at
(906) 358-4587.
Mr Mark R Bognar is licensed to practice in Michigan (license number 2901019957) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1952319832.
Healthcare Provider's Profile
Full Name | Mr Mark R Bognar |
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Gender | Male |
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Speciality | Dentist |
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Location | E 23970 Pow Wow Trail Rd, Watersmeet, Michigan |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1952319832
- Provider Enumeration Date: 08/04/2006
- Last Update Date: 03/09/2009
Medicare PECOS Information:
- PECOS PAC ID: 3476850488
- Enrollment ID: I20160318000058
Medical Identifiers
Medical identifiers for Mr Mark R Bognar such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1952319832 | NPI | - | NPPES |
33731100 | Medicaid | WI | |
45575 | Other | WI | SECURITY HEALTH PLAN |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
122300000X | Dentist | 3856015 (Wisconsin) | Secondary |
122300000X | Dentist | 2901019957 (Michigan) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Mark R Bognar is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Mr Mark R Bognar, DDS Po Box 249, Watersmeet, MI 49969-0249 Ph: (906) 358-4587 | Mr Mark R Bognar, DDS E 23970 Pow Wow Trail Rd, Lac Vieux Desert Health Center, Watersmeet, MI 49969-0249 Ph: (906) 358-4587 |
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