Individual
DALLAS BOGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4075 E 128TH AVE, THORNTON, CO 80241-2201
(303) 925-4210
(303) 925-4212
Mailing address
PO BOX 800022, KANSAS CITY, MO 64180-0022
(800) 953-0104
(303) 765-6670
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
48225
WI
207Q00000X
Family Medicine Physician
DR.0034837
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34683800
—
WI
Enumeration date
06/17/2006
Last updated
11/04/2025
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