Individual
DR. JAY BRADFORD FOGLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1275 NE FRANKLIN AVE, SUITE A, BREMERTON, WA 98311-3005
(360) 377-0803
Mailing address
14643 CENTRAL VALLEY RD NW, POULSBO, WA 98370-8167
(206) 992-4148
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
60140278
WA
Other
Enumeration date
06/23/2010
Last updated
06/23/2010
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