Provider Demographics
NPI:1073525622
Name:RODGERS, CHARLES F (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:F
Last Name:RODGERS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5731 E SANTA ANA CANYON RD
Mailing Address - Street 2:STE. A
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92807-3234
Mailing Address - Country:US
Mailing Address - Phone:714-998-2956
Mailing Address - Fax:714-998-7331
Practice Address - Street 1:2860 MICHELLE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92606-1009
Practice Address - Country:US
Practice Address - Phone:714-508-3600
Practice Address - Fax:714-368-2092
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-12
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA353241223G0001X
CO93561223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice