Provider Demographics
NPI:1639157225
Name:ROGERS, WILLIAM C (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:C
Last Name:ROGERS
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 1:5850 BOYMEL DR
Mailing Address - Street 2:SUITE #4
Mailing Address - City:FAIRFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45014-8529
Mailing Address - Country:US
Mailing Address - Phone:513-874-0860
Mailing Address - Fax:513-874-0856
Practice Address - Street 1:5850 BOYMEL DR
Practice Address - Street 2:SUITE #4
Practice Address - City:FAIRFIELD
Practice Address - State:OH
Practice Address - Zip Code:45014-8529
Practice Address - Country:US
Practice Address - Phone:513-874-0860
Practice Address - Fax:513-874-0856
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-01-67871223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice