Individual
MARK KOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8752 ATLANTIC AVE, DELRAY BEACH, FL 33446-9814
(561) 206-2973
Mailing address
8278 BANPO BRIDGE WAY, DELRAY BEACH, FL 33446-0031
(201) 406-6596
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
22DI02581400
NJ
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DN24843
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/16/2014
Last updated
10/20/2025
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