Provider Demographics
NPI:1457448391
Name:ROGERS, STERLING (DDS)
Entity Type:Individual
Prefix:
First Name:STERLING
Middle Name:
Last Name:ROGERS
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 1:3208 N ACADEMY BLVD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80917-5161
Mailing Address - Country:US
Mailing Address - Phone:719-597-3700
Mailing Address - Fax:719-597-7507
Practice Address - Street 1:3208 N ACADEMY BLVD
Practice Address - Street 2:SUITE 110
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80917-5161
Practice Address - Country:US
Practice Address - Phone:719-597-3700
Practice Address - Fax:719-597-7507
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO79891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice