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General NPI Number Information
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NPI Number | 1467828244
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Entity Type | Individual
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Provider Name | BRITTANY ROGGE RDH
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Gender | Female
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Dates
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Enumeration Date | 08/17/2015
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Last Update Date | 08/17/2015
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Provider Practice Location Address
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Address Line | 203 LOCUST ST
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City | DU BOIS
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State | NE
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Zip | 68345-5048
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Country | US
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Telephone | 308-962-6433
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Fax |
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Provider Business Mailing Address
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Address Line | 203 LOCUST ST
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City | DU BOIS
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State | NE
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Zip | 68345-5048
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Country | US
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Telephone | 308-962-6433
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Fax |
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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 | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 2628
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License Number State | NE
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