Individual
DR. MARK KOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
30 E 40TH ST, SUITE 207, NEW YORK, NY 10016-1201
(212) 696-4979
(212) 447-5786
Mailing address
30 E 40TH ST, SUITE 207, NEW YORK, NY 10016-1201
(212) 696-4979
(212) 447-5786
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
051647-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02567251
—
NY
Enumeration date
04/26/2007
Last updated
07/09/2007
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