Provider Demographics
NPI:1083638183
Name:ROGGE, CLIFF EDWARD (DDS)
Entity Type:Individual
Prefix:MR
First Name:CLIFF
Middle Name:EDWARD
Last Name:ROGGE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 S HOVER ST
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80501-7900
Mailing Address - Country:US
Mailing Address - Phone:303-485-8888
Mailing Address - Fax:303-485-7777
Practice Address - Street 1:920 S HOVER ST
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-7900
Practice Address - Country:US
Practice Address - Phone:303-485-8888
Practice Address - Fax:303-485-7777
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO68061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO6806OtherSTATE ID
COBR4081763OtherDRUG ID