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Individual

DR. MICHAEL SCOTT BOGAARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
2900 DOOLITTLE DR, ELLSWORTH AFB, SD 57706-4821
(605) 385-3281
(605) 385-2424
Mailing address
2900 DOOLITTLE DR, ELLSWORTH AFB, SD 57706-4821
(605) 385-3281
(605) 385-2424

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2207
CO

Other

Enumeration date
08/30/2005
Last updated
08/21/2007
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