Provider Demographics
NPI:1306012695
Name:RODGERS, VALARIE ANNE (DDS)
Entity Type:Individual
Prefix:DR
First Name:VALARIE
Middle Name:ANNE
Last Name:RODGERS
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 1:2314 N 2ND ST
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:IA
Mailing Address - Zip Code:52732-2434
Mailing Address - Country:US
Mailing Address - Phone:563-242-1565
Mailing Address - Fax:563-242-0095
Practice Address - Street 1:2314 N 2ND ST
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:IA
Practice Address - Zip Code:52732-2434
Practice Address - Country:US
Practice Address - Phone:563-242-1565
Practice Address - Fax:563-242-0095
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-06
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06692122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice