Individual
LYELL R HOGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1010 4TH ST SW STE 340, MASON CITY, IA 50401-2856
(641) 424-1656
(641) 424-2219
Mailing address
1010 4TH ST SW STE 340, MASON CITY, IA 50401-2856
(641) 424-1656
(641) 424-2219
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
07778
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0208520
—
IA
Enumeration date
07/08/2006
Last updated
07/08/2007
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