Provider Demographics
NPI:1407368517
Name:ROGERS, CAROLYN (RDH)
Entity Type:Individual
Prefix:MS
First Name:CAROLYN
Middle Name:
Last Name:ROGERS
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 COUNTY ST
Mailing Address - Street 2:
Mailing Address - City:ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02703-3535
Mailing Address - Country:US
Mailing Address - Phone:508-222-5950
Mailing Address - Fax:508-222-2729
Practice Address - Street 1:202 COUNTY ST
Practice Address - Street 2:
Practice Address - City:ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02703-3535
Practice Address - Country:US
Practice Address - Phone:508-222-5950
Practice Address - Fax:508-222-2729
Is Sole Proprietor?:No
Enumeration Date:2017-10-30
Last Update Date:2017-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADH8662124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist