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Individual

ELIZABETH A FOGE

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
R.D.H.

Contact information

Practice address
1515 26TH AVE E, BRADENTON, FL 34208-7707
(941) 708-7607
(941) 708-7618
Mailing address
1515 26TH AVE E, BRADENTON, FL 34208-7707
(941) 708-7607
(941) 708-7618

Taxonomy

Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH12001
FL

Other

Enumeration date
04/06/2006
Last updated
07/08/2007
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