MEDICARE: DR. ROSEANNE C RODGERS DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	9343	SC

General Provider Information

NPI Number	:	1508034273
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROSEANNE C RODGERS DDS

Provider Business Mailing Address
First Line	:	197 BERKSHIRE LOOP
Second Line	:
City	:	PAWLEYS ISLAND
State	:	SC
Zip	:	29585-6337
Country	:	US
Telephone Number	:	443-796-5982
Fax Number	:

Provider Business Practice Location Address
First Line	:	1209 N FRASER ST
Second Line	:
City	:	GEORGETOWN
State	:	SC
Zip	:	29440-2853
Country	:	US
Telephone Number	:	843-546-2273
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/15/2008
Last Update Date	:	11/04/2024

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