Organization
TARA A FOGLE, D.M.D, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TARA AUSTIN FOGLE DMD (OWNER/PRESIDENT)
(770) 461-1141
Entity
Organization
Contact information
Practice address
98 N PARK DR, FAYETTEVILLE, GA 30214-1645
(770) 461-1141
(770) 461-1143
Mailing address
98 N PARK DR, FAYETTEVILLE, GA 30214-1645
(770) 461-1141
(770) 461-1143
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
01/11/2021
Last updated
01/11/2021
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