Healthcare Provider Details

I. General information

NPI: 1184717613
Provider Name (Legal Business Name): RALPH E ROGLER DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 NAUGHRIGHT RD
LONG VALLEY NJ
07853-3800
US

IV. Provider business mailing address

325 NAUGHRIGHT RD
LONG VALLEY NJ
07853-3800
US

V. Phone/Fax

Practice location:
  • Phone: 908-850-0506
  • Fax: 908-979-9917
Mailing address:
  • Phone: 908-850-0506
  • Fax: 908-979-9917

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number10253
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: