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General NPI Number Information
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NPI Number | 1912421843
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Entity Type | Individual
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Provider Name | PETER HUTTON VOGEN DMD, MS
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Gender | Male
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Dates
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Enumeration Date | 08/02/2017
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Last Update Date | 10/26/2023
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Provider Practice Location Address
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Address Line | 6037 BESSINGER ST RM 174
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City | FORT SILL
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State | OK
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Zip | 73503
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Country | US
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Telephone | 580-442-0121
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Fax |
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Provider Business Mailing Address
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Address Line | 6037 BESSINGER ST RM 174
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City | FORT SILL
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State | OK
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Zip | 73503-4406
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Country | US
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Telephone | 580-442-0121
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 019031275
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 91
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License Number State | OK
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