Individual
DR. LARRY S WOGMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
340 SE HIGH ST., MITCHELL, OR 97750-0304
(541) 462-3313
Mailing address
712 JAY ST., FOSSIL, OR 97830-0307
(541) 763-2725
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D9235
OR
Other
Enumeration date
10/05/2009
Last updated
10/05/2009
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