Provider Demographics
NPI:1992324750
Name:RICHARD L ROGERS DDS PA
Entity type:Organization
Organization Name:RICHARD L ROGERS DDS PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:L
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:301-663-1700
Mailing Address - Street 1:2100 OLD FARM DR STE 1F
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-9494
Mailing Address - Country:US
Mailing Address - Phone:301-663-1700
Mailing Address - Fax:301-696-2837
Practice Address - Street 1:2100 OLD FARM DR STE 1F
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-9494
Practice Address - Country:US
Practice Address - Phone:301-663-1700
Practice Address - Fax:301-696-2837
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-13
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental