Provider Demographics
NPI:1184601601
Name:ROGERS, W CURTIS (DDS)
Entity type:Individual
Prefix:DR
First Name:W
Middle Name:CURTIS
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:P O BOX 68
Mailing Address - Street 2:162 SOUTH ALLISON AVE
Mailing Address - City:GREENFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65661-0068
Mailing Address - Country:US
Mailing Address - Phone:417-637-5933
Mailing Address - Fax:417-637-5935
Practice Address - Street 1:162 SOUTH ALLISON AVE
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:MO
Practice Address - Zip Code:65661
Practice Address - Country:US
Practice Address - Phone:417-637-5933
Practice Address - Fax:417-637-5935
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-27
Last Update Date:2015-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO137141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice