Provider Demographics
NPI:1508034273
Name:RODGERS, ROSEANNE C (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROSEANNE
Middle Name:C
Last Name:RODGERS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1430 JOHN WESLEY GILBERT DRIVE
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30912-0001
Mailing Address - Country:US
Mailing Address - Phone:706-721-2371
Mailing Address - Fax:706-721-6778
Practice Address - Street 1:TAYLOR MADE SMILES
Practice Address - Street 2:303 S. BROAD STREET
Practice Address - City:MONROE
Practice Address - State:GA
Practice Address - Zip Code:30655-2119
Practice Address - Country:US
Practice Address - Phone:770-267-4404
Practice Address - Fax:706-721-6778
Is Sole Proprietor?:No
Enumeration Date:2008-02-15
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC9343122300000X, 1223G0001X
GADNF0004551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist