Provider Demographics
NPI:1093827040
Name:ROGERS, RON B (DDS, MS)
Entity Type:Individual
Prefix:
First Name:RON
Middle Name:B
Last Name:ROGERS
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1001 MEDICAL PLAZA DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-3241
Mailing Address - Country:US
Mailing Address - Phone:281-367-1617
Mailing Address - Fax:281-367-3980
Practice Address - Street 1:1001 MEDICAL PLAZA DR
Practice Address - Street 2:SUITE 300
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-3241
Practice Address - Country:US
Practice Address - Phone:281-367-1617
Practice Address - Fax:281-367-3980
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX91131223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics