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NPI Code Detail

MEDICARE: DR. BRUCE N ROGERS DDS

MEDICARE:  DR. BRUCE N ROGERS  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
11223G0001XGeneral Practice Dentistry4529NC

General Provider Information

NPI Number : 1518962372
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BRUCE N ROGERS DDS
Provider Business Mailing Address
First Line : 7008 MAY LAKE RD
Second Line :
City : CLEMMONS
State : NC
Zip : 27012-9732
Country : US
Telephone Number : 336-716-2183
Fax Number :
Provider Business Practice Location Address
First Line : 131 MILLER ST
Second Line :
City : WINSTON-SALEM
State : NC
Zip : 27103-2508
Country : US
Telephone Number : 336-716-2183
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2005
Last Update Date : 07/08/2007

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Directions to “ DR. BRUCE N ROGERS DDS” Practice Location

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