Individual
DR. SCOTT PAUL FOGEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1521 N CONVENT ST STE 600, BOURBONNAIS, IL 60914-1486
(815) 933-5173
(815) 933-5191
Mailing address
1521 N CONVENT ST STE 600, BOURBONNAIS, IL 60914-1486
(815) 933-5173
(815) 933-5191
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019026391
IL
Other
Enumeration date
11/29/2012
Last updated
11/29/2012
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