Bogard, Ryan Drew
Bogard, Ryan Drew is an sole proprietor health care provider with primary practice located at 310 Tri State Pkwy Ste 100 , Gurnee IL 60031-5282. He recently has only one registered license in Dental Providers / Periodontics, which is considered as his primary health care specialty. Bogard, Ryan Drew can be contacted via phone (314) 583-3104.Contact Information
Primary practice address
310 Tri State Pkwy Ste 100
Gurnee IL 60031-5282
Phone: (314) 583-3104
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Periodontics | 1223P0300X | 019.033452 | Illinois |
Profile Details
| NPI number | 1740925304 |
|---|---|
| LBN Legal business name | Bogard, Ryan Drew |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 28th, 2022 |
| Last updated | Apr 28th, 2022 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1740925304 | NPPES |
| Illinois | Other | 019.033452 | LICENSE NUMBER |
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