Christy Jo Fogarty, RDH, ADT Valid NPI
Individual provider · Dental Therapist · Minneapolis, MN
- NPI
- 1649550260
- Type
- Individual (Type 1)
- Primary specialty
- Dental Therapist
- Specialty group
- Dental Providers
- Taxonomy code
- 125J00000X
- License number
- DT02 (MN)
- Sex
- Female
- Sole proprietor
- No
- Enumerated
- 2011-08-26
- Last updated
- 2017-11-14
Practice location
636 Broadway St Ne
Minneapolis, MN 55413-2164
(612) 746-1530