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General NPI Number Information
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NPI Number | 1881140473
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Entity Type | Individual
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Provider Name | LEAH ROGOWSKI D.M.D.
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Gender | Female
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Dates
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Enumeration Date | 09/01/2016
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Last Update Date | 05/27/2022
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Provider Practice Location Address
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Address Line | 2963 W ELLIOT RD STE 1
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City | CHANDLER
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State | AZ
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Zip | 85224-1633
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Country | US
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Telephone | 480-220-3894
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Fax |
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Provider Business Mailing Address
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Address Line | 608 S RIATA ST
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City | GILBERT
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State | AZ
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Zip | 85296-2928
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Country | US
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Telephone | 480-220-3894
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | D011241
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN 22123
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License Number State | FL
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