Individual
MAGGIE ROSE FOGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
49 HARRY KEMP WAY, PROVINCETOWN, MA 02657-1618
(508) 487-9395
Mailing address
20 STARLIGHT LN, EASTHAM, MA 02642-3022
(508) 246-4466
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH89077
MA
Other
Enumeration date
09/06/2018
Last updated
09/06/2018
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