Provider Demographics
NPI:1912027269
Name:ROGER D. BATCHELDER DDS PC
Entity Type:Organization
Organization Name:ROGER D. BATCHELDER DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:DEAN
Authorized Official - Last Name:BATCHELDER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:307-235-9198
Mailing Address - Street 1:1555 E 12TH ST
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82601-4002
Mailing Address - Country:US
Mailing Address - Phone:307-235-9198
Mailing Address - Fax:307-235-3165
Practice Address - Street 1:1555 E 12TH ST
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-4002
Practice Address - Country:US
Practice Address - Phone:307-235-9198
Practice Address - Fax:307-235-3165
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY7291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty