Provider Demographics
NPI:1588184451
Name:RODGERS, ERIN (DDS)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
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 1:8303 UNIVERSITY EXEC PARK DR STE 430
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28262-3356
Mailing Address - Country:US
Mailing Address - Phone:980-729-5200
Mailing Address - Fax:704-637-0481
Practice Address - Street 1:140 MAHALEY AVE STE B
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144-2449
Practice Address - Country:US
Practice Address - Phone:704-637-5506
Practice Address - Fax:704-637-0481
Is Sole Proprietor?:No
Enumeration Date:2017-06-22
Last Update Date:2017-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC107401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC10740OtherNC DENTAL BOARD