Provider Demographics
NPI:1457483968
Name:ROGGE, BERND JAMES (DDS)
Entity Type:Individual
Prefix:DR
First Name:BERND
Middle Name:JAMES
Last Name:ROGGE
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 1:838 WALKER RD
Mailing Address - Street 2:STE 21-1
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-2751
Mailing Address - Country:US
Mailing Address - Phone:302-736-1423
Mailing Address - Fax:
Practice Address - Street 1:838 WALKER RD
Practice Address - Street 2:STE 21-1
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-2751
Practice Address - Country:US
Practice Address - Phone:302-736-1423
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEDE 9871223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice