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General NPI Number Information
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NPI Number | 1578701231
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Entity Type | Organization
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Legal Business Name | INDIA ROGERS
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Dates
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Enumeration Date | 02/03/2009
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Last Update Date | 02/04/2009
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Provider Practice Location Address
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Address Line | 1101 PENNSYLVANIA AVE NW 7TH FLOOR
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City | WASHINGTON
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State | DC
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Zip | 20004-2514
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Country | US
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Telephone | 202-756-7505
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Fax |
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Provider Business Mailing Address
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Address Line | 1101 PENNSYLVANIA AVE NW 7TH FLOOR
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City | WASHINGTON
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State | DC
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Zip | 20004-2514
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CEO/PRINICPAL
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Name | DR. INDIA JENEE ROGERS
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Credential | D.D.S
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Telephone | 202-756-7505
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DEN1000590
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License Number State | DC
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