Provider Demographics
NPI:1548328206
Name:OGIE, ROBERT ARTHUR
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ARTHUR
Last Name:OGIE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2451 S AVENUE A
Mailing Address - Street 2:23
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-7133
Mailing Address - Country:US
Mailing Address - Phone:928-726-9262
Mailing Address - Fax:
Practice Address - Street 1:2451 S AVENUE A
Practice Address - Street 2:23
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-7133
Practice Address - Country:US
Practice Address - Phone:928-726-9262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ55381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1368901OtherUNITED CONCORDIA ID
AZ1368901OtherUNITED CONCORDIA ID