Provider Demographics
NPI:1639285935
Name:ROGERS, DANIEL J (DDS)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:J
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 1:36444 WARREN RD
Mailing Address - Street 2:
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48185-2093
Mailing Address - Country:US
Mailing Address - Phone:734-261-6060
Mailing Address - Fax:734-261-6095
Practice Address - Street 1:36444 WARREN RD
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48185-2093
Practice Address - Country:US
Practice Address - Phone:734-261-6060
Practice Address - Fax:734-261-6095
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI119281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice