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Organization
MOGELL DENTAL ASSOCIATES
Active
Organization
MOGELL DENTAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH A MOGELL DMD (PRESIDENT)
(561) 394-9000
Entity
Organization
Contact information
Practice address
2900 N MILITARY TRL, STE 212, BOCA RATON, FL 33431-6365
(561) 394-9000
(561) 488-1102
Mailing address
2900 N MILITARY TRL, STE 212, BOCA RATON, FL 33431-6365
(561) 394-9000
(561) 488-1102
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN10118
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12472337
CAQH
FL
Enumeration date
05/24/2013
Last updated
05/24/2013
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