Individual
ANDREW JACOB FOGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
331 S STATE ROAD 135 STE D, GREENWOOD, IN 46142-1453
(317) 859-0600
Mailing address
307 N PENNSYLVANIA ST APT 911, INDIANAPOLIS, IN 46204-2311
(317) 450-5364
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12013380A
IN
Other
Enumeration date
06/15/2020
Last updated
06/15/2020
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