Provider Demographics
NPI:1669169553
Name:BOGER, DAVID QUINN (DMD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:QUINN
Last Name:BOGER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10579 BRADFORD RD STE 100
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80127-4247
Mailing Address - Country:US
Mailing Address - Phone:303-933-2273
Mailing Address - Fax:
Practice Address - Street 1:10579 BRADFORD RD STE 100
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80127-4247
Practice Address - Country:US
Practice Address - Phone:303-933-2273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-20
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.002059601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice