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Individual

ELENA KOGAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
860 W REDLANDS BLVD STE 105, REDLANDS, CA 92373-8010
(909) 793-5270
(909) 793-7679
Mailing address
860 W REDLANDS BLVD # 105, REDLANDS, CA 92373-8010
(909) 793-5270
(909) 793-7679

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
49427
CA

Other

Enumeration date
07/10/2007
Last updated
07/10/2007
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