Provider Demographics
NPI:1457474744
Name:ROGER K. PIKE DDS
Entity Type:Organization
Organization Name:ROGER K. PIKE DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:PIKE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:812-934-3838
Mailing Address - Street 1:200 CROSS COUNTY PLZ # A
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47006-8914
Mailing Address - Country:US
Mailing Address - Phone:812-934-3838
Mailing Address - Fax:812-934-5985
Practice Address - Street 1:200 CROSS COUNTY PLZ # A
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:IN
Practice Address - Zip Code:47006-8914
Practice Address - Country:US
Practice Address - Phone:812-934-3838
Practice Address - Fax:812-934-5985
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12009140A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty