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General NPI Number Information
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NPI Number | 1093866352
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Entity Type | Individual
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Provider Name | ROGELIO ROGER LI D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 01/15/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1439 CEDARWOOD LN STE D
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City | PLEASANTON
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State | CA
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Zip | 94566-6127
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Country | US
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Telephone | 925-462-7212
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Fax | 925-462-7258
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Provider Business Mailing Address
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Address Line | 3694 HAPPY VALLEY RD
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City | LAFAYETTE
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State | CA
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Zip | 94549-3040
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Country | US
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Telephone | 925-462-7212
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Fax | 925-462-7258
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 03551
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License Number State | CA
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