Icboggan, INC
NPI #1962035261 in Lafayette, California
Provider Information
- NPI Number
- 1962035261
- Entity Type
- Organization
- Organization Name
- Icboggan, INC
- Primary Specialty
- Specialist
- Enumeration Date
- Feb 15, 2020
- Last Updated
- Jul 24, 2022
Practice Location
- Address
- 3799 MT DIABLO BLVD UNIT 200
- City
- Lafayette
- State
- California
- ZIP Code
- 94549-3545
- Phone
- (925) 962-7450
Authorized Official
- Name
- NERISSA T BOGGAN, RDH
- Title
- RDH
- Phone
- (925) 962-7450
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dental Hygienist |
| Specialist |
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