Individual
DR. DEANA R FUGATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1213 W LINCOLN AVE, GOSHEN, IN 46526-2130
(865) 208-5147
Mailing address
1213 W LINCOLN AVE, GOSHEN, IN 46526-2130
(574) 533-6911
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12012647A
IN
122300000X
Dentist
8338
NC
Other
Enumeration date
01/11/2006
Last updated
06/15/2022
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