Provider Demographics
NPI:1942337050
Name:HOGAN, ROBIN D (DDS)
Entity type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:D
Last Name:HOGAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2811 COMSTOCK ST
Mailing Address - Street 2:
Mailing Address - City:MILES CITY
Mailing Address - State:MT
Mailing Address - Zip Code:59301-5754
Mailing Address - Country:US
Mailing Address - Phone:406-874-8711
Mailing Address - Fax:406-851-5773
Practice Address - Street 1:2811 COMSTOCK ST
Practice Address - Street 2:
Practice Address - City:MILES CITY
Practice Address - State:MT
Practice Address - Zip Code:59301-5754
Practice Address - Country:US
Practice Address - Phone:406-874-8711
Practice Address - Fax:406-851-5773
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT22051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0030888Medicaid
MT0033215OtherCHIP