Provider Demographics
NPI:1033299060
Name:MCDOUGAL, ROGER ALEXANDER (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:ROGER
Middle Name:ALEXANDER
Last Name:MCDOUGAL
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Gender:M
Credentials:DDS, MS
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Mailing Address - Street 1:5826 FAYETTEVILLE RD
Mailing Address - Street 2:SUITE #209
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-8684
Mailing Address - Country:US
Mailing Address - Phone:919-806-8667
Mailing Address - Fax:919-806-5401
Practice Address - Street 1:5826 FAYETTEVILLE RD
Practice Address - Street 2:SUITE #209
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-8684
Practice Address - Country:US
Practice Address - Phone:919-806-8667
Practice Address - Fax:919-806-5401
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC68441223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics