MEDICARE: DR. CHARLES 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
1	122300000X	Dentist	4117	CT

General Provider Information

NPI Number	:	1801029228
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHARLES ROGERS DDS

Provider Business Mailing Address
First Line	:	53 NORTH ST
Second Line	:
City	:	DANBURY
State	:	CT
Zip	:	06810-5637
Country	:	US
Telephone Number	:	203-743-6083
Fax Number	:

Provider Business Practice Location Address
First Line	:	53 NORTH ST
Second Line	:
City	:	DANBURY
State	:	CT
Zip	:	06810-5637
Country	:	US
Telephone Number	:	203-743-6083
Fax Number	:

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

Provider Enumeration Date	:	09/02/2009
Last Update Date	:	09/02/2009

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Directions to “ DR. CHARLES ROGERS DDS” Practice Location

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