Individual
MR. GERALD DALE OGDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1221 JOHNSON AVE, SUITE 200, BRIDGEPORT, WV 26330-1392
(304) 842-7591
Mailing address
1221 JOHNSON AVE, SUITE 200, BRIDGEPORT, WV 26330-1392
(304) 842-7591
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2006
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810000304
—
WV
01
—
46984
UNITED CONCORDIA
WV
Enumeration date
01/11/2007
Last updated
07/08/2007
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