Individual
DR. RANDALL T. BOGGS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3416 W LASKEY RD, TOLEDO, OH 43623-4015
(419) 473-8885
(419) 473-9995
Mailing address
3416 W LASKEY RD, TOLEDO, OH 43623-4015
(419) 473-8885
(419) 473-9995
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
15815
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005025
—
OH
05
—
016909
—
OH
05
—
0390625
—
OH
01
—
653400
UNITED CONCORDIA
OH
Enumeration date
07/18/2005
Last updated
03/19/2015
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