Provider Demographics
NPI:1558488742
Name:BATCHELDER, ROGER DEAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROGER
Middle Name:DEAN
Last Name:BATCHELDER
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 1:1555 E 12TH ST
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82601-4002
Mailing Address - Country:US
Mailing Address - Phone:307-235-9198
Mailing Address - Fax:307-235-3165
Practice Address - Street 1:1555 E 12TH ST
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-4002
Practice Address - Country:US
Practice Address - Phone:307-235-9198
Practice Address - Fax:307-235-3165
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY7291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice