Provider Demographics
NPI:1760578264
Name:SANGER, ROGER GREGORY (DDS MS)
Entity Type:Individual
Prefix:DR
First Name:ROGER
Middle Name:GREGORY
Last Name:SANGER
Suffix:
Gender:M
Credentials:DDS MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:631 E ALVIN DRIVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93906
Mailing Address - Country:US
Mailing Address - Phone:931-442-8878
Mailing Address - Fax:931-443-4611
Practice Address - Street 1:633 E ALVIN DRIVE
Practice Address - Street 2:STE B
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93906
Practice Address - Country:US
Practice Address - Phone:831-443-1177
Practice Address - Fax:831-443-0705
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA212001223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAD21200Medicaid