MEDICARE: SUSAN RUTH VOGEL RDH

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	124Q00000X	Dental Hygienist	902996	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1427227180
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN RUTH VOGEL RDH

Provider Business Mailing Address
First Line	:	1220 OAK PARK DR STE 6
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-7348
Country	:	US
Telephone Number	:	970-227-5642
Fax Number	:

Provider Business Practice Location Address
First Line	:	1220 OAK PARK DR STE 6
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-7348
Country	:	US
Telephone Number	:	970-227-5642
Fax Number	:

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

Provider Enumeration Date	:	02/27/2008
Last Update Date	:	11/09/2015

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