Individual
JESSICA VOGEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
303 E 11TH ST, RUSHVILLE, IN 46173-1312
(765) 932-2738
Mailing address
776 S DONALD ST, RUSHVILLE, IN 46173-7768
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12012721A
IN
1223G0001X
General Practice Dentistry
12012721A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12012721A
LICENSE NUMBER
IN
Enumeration date
07/03/2017
Last updated
12/11/2017
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