Provider Demographics
NPI:1083700389
Name:ROGERS, WILLIAM EUGENE (DDS)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:EUGENE
Last Name:ROGERS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 MARKET PLACE BLVD
Mailing Address - Street 2:BLDG E
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-2337
Mailing Address - Country:US
Mailing Address - Phone:865-693-2331
Mailing Address - Fax:865-691-8340
Practice Address - Street 1:140 MARKET PLACE BLVD
Practice Address - Street 2:BLDG E
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922-2337
Practice Address - Country:US
Practice Address - Phone:865-693-2331
Practice Address - Fax:865-691-8340
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN21881223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics