Ryan Drew Bogard, DDS Valid NPI
Individual provider · Periodontics · Gurnee, IL
- NPI
- 1740925304
- Type
- Individual (Type 1)
- Primary specialty
- Periodontics (Dentist)
- Specialty group
- Dental Providers
- Taxonomy code
- 1223P0300X
- License number
- 019.033452 (IL)
- Sex
- Male
- Sole proprietor
- Yes
- Enumerated
- 2022-04-28
- Last updated
- 2022-04-28
Practice location
310 Tri State Pkwy Ste 100
Gurnee, IL 60031-5282
(314) 583-3104