Provider Demographics
NPI:1417097346
Name:VOGEL, TARA LEVESQUE (DMD)
Entity Type:Individual
Prefix:DR
First Name:TARA
Middle Name:LEVESQUE
Last Name:VOGEL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 AMHERST ST
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03064-2561
Mailing Address - Country:US
Mailing Address - Phone:603-882-7578
Mailing Address - Fax:
Practice Address - Street 1:61 AMHERST ST
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03064-2561
Practice Address - Country:US
Practice Address - Phone:603-882-7578
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3292122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist