Provider Demographics
NPI:1730309493
Name:ROGERS, RICHARD DOUGLAS
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:DOUGLAS
Last Name:ROGERS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:R
Other - Middle Name:DOUGLAS
Other - Last Name:ROGERS DDS PA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2335 TAMIAMI TRAIL N
Mailing Address - Street 2:SUITE 507
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34103
Mailing Address - Country:US
Mailing Address - Phone:239-262-7700
Mailing Address - Fax:239-434-6148
Practice Address - Street 1:2335 TAMIAMI TRAIL N
Practice Address - Street 2:SUITE 507
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103
Practice Address - Country:US
Practice Address - Phone:239-262-7700
Practice Address - Fax:239-434-6148
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN6438122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist