Provider Demographics
NPI:1679092852
Name:BOGGS, JOSEPH MARC (DMD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:MARC
Last Name:BOGGS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:DR
Other - First Name:JOSEPH
Other - Middle Name:MARC
Other - Last Name:BOGGS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DR JOSEPH BOGGS,DMD
Mailing Address - Street 1:834 4TH AVE. NW
Mailing Address - Street 2:
Mailing Address - City:HICKROY
Mailing Address - State:NC
Mailing Address - Zip Code:28601
Mailing Address - Country:US
Mailing Address - Phone:803-667-1894
Mailing Address - Fax:
Practice Address - Street 1:4283 HICKORY BLVD.
Practice Address - Street 2:
Practice Address - City:GRANITE FALLS
Practice Address - State:NC
Practice Address - Zip Code:28630-2863
Practice Address - Country:US
Practice Address - Phone:828-514-9281
Practice Address - Fax:828-514-9281
Is Sole Proprietor?:No
Enumeration Date:2017-09-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10847122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC10847Other