Individual
DR. MERREDITH COLMAN BOGERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
3223 N BROAD ST, TEMPLE UNIVERSITY SCHOOL OF DENTISTRY - ROOM 2E05, PHILADELPHIA, PA 19140-5007
(215) 707-5934
(215) 707-2840
Mailing address
3223 N BROAD ST, TEMPLE UNIVERSITY SCHOOL OF DENTISTRY - ROOM 2E05, PHILADELPHIA, PA 19140-5007
(215) 707-5934
(215) 707-2840
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS-023983-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DS-023983-L
DENTAL LICENSE
PA
Enumeration date
05/21/2009
Last updated
03/07/2023
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