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Organization
SCOTT P. FOGEL DDS PC
Active
Organization
SCOTT P. FOGEL DDS PC
Active
Parent organization
SCOTT P. FOGEL DDS PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
SCOTT P. FOGEL DDS PC
Authorized official
DR. SCOTT P. FOGEL DDS (OWNER)
(815) 933-5173
Entity
Organization
Contact information
Practice address
1521 N CONVENT ST, SUITE 600, BOURBONNAIS, IL 60914-1468
(815) 933-5173
(815) 933-5191
Mailing address
1521 N CONVENT ST, SUITE 600, BOURBONNAIS, IL 60914-1468
(815) 933-5173
(815) 933-5191
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019026391
IL
Other
Enumeration date
08/17/2006
Last updated
11/26/2012
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