Individual
DR. SAMANTHA R BOGLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1202 SE PORT ST LUCIE BLVD, PORT ST LUCIE, FL 34952-5364
(772) 335-3088
Mailing address
1043 BAY COLONY DR S, JUNO BEACH, FL 33408-2103
(973) 943-9514
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
22DI02632900
NJ
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
DN1857916
MA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DN28672
FL
Other
Enumeration date
05/17/2017
Last updated
06/13/2024
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