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General NPI Number Information
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NPI Number | 1871833947
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Entity Type | Individual
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Provider Name | KRISTIN DENISE ROGERS DDS
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Gender | Female
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Dates
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Enumeration Date | 02/26/2013
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Last Update Date | 09/06/2016
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Provider Practice Location Address
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Address Line | 1780 S FRIENDSWOOD DR STE A
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City | FRIENDSWOOD
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State | TX
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Zip | 77546-5410
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Country | US
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Telephone | 314-574-8415
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Fax |
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Provider Business Mailing Address
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Address Line | 1780 S FRIENDSWOOD DR STE A
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City | FRIENDSWOOD
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State | TX
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Zip | 77546-5410
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Country | US
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Telephone | 314-574-8415
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 31907
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 31907
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 019029556
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 019029556
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License Number State | IL
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