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Individual

DR. CHAD THEODORE BOGREN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
1099 HELMO AVE N, STE 150, OAKDALE, MN 55128-6038
(651) 739-3937
(651) 739-9690
Mailing address
3201 ATWOOD CT, STILLWATER, MN 55082-6692
(651) 439-2909
(651) 351-3978

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3169
MN
152WC0802X
Corneal and Contact Management Optometrist
3169
MN
152WL0500X
Low Vision Rehabilitation Optometrist
3169
MN

Other

Enumeration date
09/11/2009
Last updated
11/30/2016
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