Provider Demographics
NPI:1619190584
Name:ROGERS, MICHAEL TOPUS (DMD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:TOPUS
Last Name:ROGERS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 YELLOW BRICK RD
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-5496
Mailing Address - Country:US
Mailing Address - Phone:973-633-0069
Mailing Address - Fax:
Practice Address - Street 1:70 E 10TH ST
Practice Address - Street 2:SUITE #1B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-5102
Practice Address - Country:US
Practice Address - Phone:212-473-3344
Practice Address - Fax:212-473-3543
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0341181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice