Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 10782 | TX |
NPI | 1053413872 |
---|---|
Provider Name | Dr. Stephen James Vogel |
First Address | Killeen, TX 76542-6038 |
Second Address | Killeen, TX 76542-6038 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/09/2006 |
Last Update Date | 08/07/2007 |