Individual
DR. CHRISTOPHER W BOGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
703 SIMON AVE, CARROLL, IA 51401-2264
(712) 792-4375
(712) 792-3371
Mailing address
703 SIMON AVE, CARROLL, IA 51401-2264
(712) 792-4375
(712) 792-3371
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
08166
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1264721
—
IA
01
—
180751
UNITED CONCORDIA ID #
IA
01
—
49002
BLUECROSS BLUESHIELD ID #
IA
Enumeration date
01/04/2007
Last updated
10/27/2015
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