Scott P. Fogel DDS PC
NPI #1750494142 in Bourbonnais, Illinois
Provider Information
- NPI Number
- 1750494142
- Entity Type
- Organization
- Organization Name
- Scott P. Fogel DDS PC
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- SCOTT P. FOGEL DDS PC
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Aug 17, 2006
- Last Updated
- Nov 26, 2012
Practice Location
- Address
- 1521 N CONVENT ST
- Address 2
- SUITE 600
- City
- Bourbonnais
- State
- Illinois
- ZIP Code
- 60914-1468
- Phone
- (815) 933-5173
Authorized Official
- Name
- DR. SCOTT P. FOGEL, DDS
- Title
- OWNER
- Phone
- (815) 933-5173
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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