Provider Demographics
NPI:1467828244
Name:ROGGE, BRITTANY (RDH)
Entity Type:Individual
Prefix:MRS
First Name:BRITTANY
Middle Name:
Last Name:ROGGE
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 1:203 LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:DU BOIS
Mailing Address - State:NE
Mailing Address - Zip Code:68345-5048
Mailing Address - Country:US
Mailing Address - Phone:308-962-6433
Mailing Address - Fax:
Practice Address - Street 1:203 LOCUST ST
Practice Address - Street 2:
Practice Address - City:DU BOIS
Practice Address - State:NE
Practice Address - Zip Code:68345-5048
Practice Address - Country:US
Practice Address - Phone:308-962-6433
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-17
Last Update Date:2015-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2628124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist