Healthcare Provider Details

I. General information

NPI: 1801946736
Provider Name (Legal Business Name): RODGER ALTON LAWTON D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 09/30/2025
Certification Date: 09/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5855 E STILL CIR
MESA AZ
85206-3631
US

IV. Provider business mailing address

402 E BRACCIANO AVE
QUEEN CREEK AZ
85140-7525
US

V. Phone/Fax

Practice location:
  • Phone: 480-248-8100
  • Fax: 480-248-8199
Mailing address:
  • Phone: 360-970-1118
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License NumberD011363
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: