Provider Demographics
NPI:1649928052
Name:ROGERS DENTAL GROUP
Entity type:Organization
Organization Name:ROGERS DENTAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:BAIRD
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-524-4000
Mailing Address - Street 1:9999 S MINGO RD STE S
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-5172
Mailing Address - Country:US
Mailing Address - Phone:918-524-4000
Mailing Address - Fax:918-505-5494
Practice Address - Street 1:9999 S MINGO RD STE S
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-5172
Practice Address - Country:US
Practice Address - Phone:918-524-4000
Practice Address - Fax:918-505-5494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-15
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty