Provider Demographics
NPI:1912421843
Name:VOGEN, PETER HUTTON (DMD, MS)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:HUTTON
Last Name:VOGEN
Suffix:
Gender:M
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6037 BESSINGER ST RM 174
Mailing Address - Street 2:
Mailing Address - City:FORT SILL
Mailing Address - State:OK
Mailing Address - Zip Code:73503-4406
Mailing Address - Country:US
Mailing Address - Phone:580-442-0121
Mailing Address - Fax:
Practice Address - Street 1:6037 BESSINGER ST RM 174
Practice Address - Street 2:
Practice Address - City:FORT SILL
Practice Address - State:OK
Practice Address - Zip Code:73503
Practice Address - Country:US
Practice Address - Phone:580-442-0121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-02
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019031275122300000X
OK911223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
No122300000XDental ProvidersDentist