Christy Jo Fogarty, RDH, ADT

NPI #1649550260 in Minneapolis, Minnesota

Provider Information

NPI Number: 1649550260
Entity Type: Individual
Name: Christy Jo Fogarty, RDH, ADT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dental Therapist
Credential: RDH, ADT
Enumeration Date: Aug 26, 2011
Last Updated: Nov 14, 2017

Practice Location

Address: 636 BROADWAY ST NE
City: Minneapolis
State: Minnesota
ZIP Code: 55413-2164
Phone: (612) 746-1530

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dental Hygienist	124Q00000X
Dental Therapist	125J00000X	Primary

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