Individual
JAN P FUGAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
348 MILTON AVE, BALLSTON SPA, NY 12020-1415
(518) 885-7551
(518) 885-8060
Mailing address
348 MILTON AVE, BALLSTON SPA, NY 12020-1415
(518) 885-7551
(518) 885-8060
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
5620-015
WI
122300000X
Dentist
Primary
NY052523-1
NY
Other
Enumeration date
05/14/2007
Last updated
07/08/2007
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