| Scott P. Fogel Dds Pc | |
|
1521 N Convent St Suite 600 Bourbonnais IL 60914-1468 | |
| (815) 933-5173 | |
| (815) 933-5191 |
| Full Name | Scott P. Fogel Dds Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1521 N Convent St, Bourbonnais, Illinois |
| Authorized Official Name and Position | Scott P. Fogel (OWNER) |
| Authorized Official Contact | 8159335173 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Scott P. Fogel Dds Pc 1521 N Convent St Suite 600 Bourbonnais IL 60914-1468 Ph: (815) 933-5173 | Scott P. Fogel Dds Pc 1521 N Convent St Suite 600 Bourbonnais IL 60914-1468 Ph: (815) 933-5173 |
| NPI Number | 1750494142 |
|---|---|
| Provider Enumeration Date | 08/17/2006 |
| Last Update Date | 11/26/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750494142 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 019026391 (Illinois) | Primary |
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