Provider Demographics
NPI:1700856234
Name:ROGOFF, ELLIOT R (DDS)
Entity Type:Individual
Prefix:DR
First Name:ELLIOT
Middle Name:R
Last Name:ROGOFF
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 1:101 MILLBURN AVE
Mailing Address - Street 2:
Mailing Address - City:MILLBURN
Mailing Address - State:NJ
Mailing Address - Zip Code:07041-1917
Mailing Address - Country:US
Mailing Address - Phone:973-763-3373
Mailing Address - Fax:
Practice Address - Street 1:101 MILLBURN AVE
Practice Address - Street 2:
Practice Address - City:MILLBURN
Practice Address - State:NJ
Practice Address - Zip Code:07041-1917
Practice Address - Country:US
Practice Address - Phone:973-763-3373
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ96381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice