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Individual
DR. LISA A FOGLE
Active
Individual
DR. LISA A FOGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3254
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0103480
BLUE CROSS #
AZ
01
—
191092
UNITED CONCORDIA PROVIDER
AR
01
—
877350
CMDP PROVIDER #
AZ
Enumeration date
04/25/2006
Last updated
07/13/2026
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