Provider Demographics
NPI:1962580373
Name:ROHRS, JASON LEE
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:LEE
Last Name:ROHRS
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:JASON
Other - Middle Name:LEE
Other - Last Name:ROHRS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:229 MAIN STREET
Mailing Address - Street 2:P.O. BOX 249
Mailing Address - City:LOUISVILLE
Mailing Address - State:NE
Mailing Address - Zip Code:68037-0249
Mailing Address - Country:US
Mailing Address - Phone:402-234-3000
Mailing Address - Fax:402-234-3054
Practice Address - Street 1:229 MAIN STREET
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:NE
Practice Address - Zip Code:68037-0249
Practice Address - Country:US
Practice Address - Phone:402-234-3000
Practice Address - Fax:402-234-3054
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE63851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice