Individual
DYLAN W FOGEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1460 W SOUTH PARK AVE, OSHKOSH, WI 54902-6677
(920) 303-1803
Mailing address
1460 W SOUTH PARK AVE, OSHKOSH, WI 54902-6677
(920) 303-1803
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1002226
WI
Other
Enumeration date
11/27/2019
Last updated
11/27/2019
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