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General NPI Number Information
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NPI Number | 1871698423
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Entity Type | Organization
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Legal Business Name | ROGERS FAMILY DENTISTRY PA
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Dates
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Enumeration Date | 09/14/2006
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Last Update Date | 02/02/2015
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Provider Practice Location Address
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Address Line | 1939 N 11TH ST
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City | ARKANSAS CITY
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State | KS
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Zip | 67005-1724
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Country | US
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Telephone | 620-442-5660
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Fax | 620-442-5682
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Provider Business Mailing Address
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Address Line | 1939 N 11TH ST
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City | ARKANSAS CITY
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State | KS
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Zip | 67005-1724
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Country | US
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Telephone | 620-442-5660
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Fax | 620-442-5682
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PAUL NICHOLAS ROGERS
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Credential | DDS
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Telephone | 620-442-5660
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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 | KS 5511
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License Number State | KS
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