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Individual

WILLIAM P BOGGESS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.M.D.

Contact information

Practice address
480 CENTRAL AVE, JBPHH, HI 96860-4908
(808) 473-3430
Mailing address
480 CENTRAL AVE, PEARL HARBOR, HI 96860-4908
(808) 473-3430

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6934
KY
1223X0008X
Oral and Maxillofacial Radiology Dentistry
6934
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
60069341
KY
01
844023
UNITED CONCORDIA
KY
01
YD29
BCBS FEDERAL
KY
Enumeration date
01/30/2006
Last updated
12/13/2023
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