MEDICARE: DR. JOHN HENRY VOGEL DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	1972	AZ

General Provider Information

NPI Number	:	1255396586
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN HENRY VOGEL DDS

Provider Business Mailing Address
First Line	:	1544 W OSBORN RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85015-5847
Country	:	US
Telephone Number	:	602-279-2386
Fax Number	:	602-277-8224

Provider Business Practice Location Address
First Line	:	1544 W OSBORN RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85015-5847
Country	:	US
Telephone Number	:	602-279-2386
Fax Number	:	602-277-8224

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/19/2006
Last Update Date	:	07/08/2007

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